Rotator cuff disorders are irritations in or damage to tendons around the shoulder. These disorders include inflammation of the tendons (tendonitis) or the bursa (bursitis), a calcium buildup in the tendons, or partial or complete tears of the tendon.

The rotator cuff is a group of tendons and their related muscles that helps keep the upper arm bone securely placed, or seated, in the socket of the shoulder joint. Problems related to the rotator cuff can cause shoulder pain and reduced mobility. These types of problems may develop as a person ages and the rotator cuff gradually breaks down (degeneration).

Arthroscopy uses a thin viewing scope called an arthroscope that is inserted into a joint through a small incision in the skin. Then the surgeon will remove loose fragments of tendon and bursa and other debris from inside the irritated, injured, or torn area of the subacromial space (debridement). Additional instruments are then arthroscopically inserted to shave the bone or remove growths. This type of surgery is done on an outpatient basis.

You often will have general anesthesia during arthroscopy. Occasionally, you may have a regional nerve block, either alone or with general anesthesia.

• If a nerve block alone is done, you may be awake. You will not feel any pain; however, you may feel a sensation of pulling or tugging during the procedure.
• Regional nerve blocks are sometimes used in addition to general anesthesia to help manage pain after surgery.

Most rotator cuff disorders are treated without surgery. However, surgery may be considered if the injury is very severe. Surgery also may be recommended if the shoulder does not respond well to an adequate trial of nonsurgical treatment (rest, ice, use of nonsteroidal anti-inflammatory drugs, and physical therapy).

Surgery for rotator cuff disorders are done to:

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• Repair tendon tears and smooth the underside of the upper point of the shoulder blade (acromion) to make more room for the tendon and bursa.
• Restore strength and use of the shoulder.