What is the rotator cuff?
The rotator cuff is a group of four tendons that surround the shoulder joint, centring the ball in the socket and powering lifting and rotation. Cuff tendons can tear suddenly in an injury, or gradually with age-related wear.
Common symptoms
- Pain over the outside of the shoulder and upper arm, often worse at night
- Pain reaching overhead, behind the back, or into a sleeve
- Weakness lifting the arm or rotating outwards
- Clicking or catching with movement
An MRI scan is usually arranged before your consultation, as it shows the size and pattern of the tear and the quality of the muscle.
Non-surgical treatment
Many tears — particularly degenerative tears in less active patients — are well managed without surgery:
- Structured physiotherapy to restore mechanics and strengthen the remaining cuff
- Anti-inflammatory measures
- A corticosteroid injection for pain control where appropriate
Arthroscopic rotator cuff repair
Repair is recommended for acute tears in active patients, and for tears that remain painful and weak despite rehabilitation. The torn tendon is reattached to the bone using small anchors through keyhole (arthroscopic) incisions.
- Usually day surgery or one night in hospital
- A sling protects the repair for around six weeks
- Physiotherapy progresses from passive motion to strengthening
- Tendon healing is gradual — full recovery takes 4–6 months, sometimes longer for large tears
REGENETEN bioinductive patch for rotator cuff repair
The REGENETEN patch is a small, absorbable scaffold made from purified bovine (cow-derived) collagen. It is placed over the tendon during keyhole surgery to support the body’s healing response and the formation of tendon-like tissue. In a full-thickness tear, it can supplement the sutured repair; it does not replace reattaching the torn tendon to bone. The implant is gradually absorbed. Manufacturer information.
What might it add to a standard repair?
A randomised trial of selected medium-to-large full-thickness tears found fewer repeat tears on MRI at two years when a bioinductive collagen implant was added. However, patient-reported outcomes were similar between the groups. Better structural healing does not necessarily mean less pain, faster recovery or better function for every patient. Two-year randomised trial.
Suitability, risks and rehabilitation
The decision depends on the tear pattern, tendon quality and your circumstances. Surgery is required and carries risks, including infection, stiffness and failure to heal. Inflammation and stiffness requiring further treatment have also been reported with collagen implants; a separate retrospective study found more reoperations for these problems in its implant group. Comparative safety study.
Discuss the implant’s animal origin, any relevant allergies, suitability and additional costs with your surgeon. A patch does not remove the need to protect the repair and follow a tailored rehabilitation programme. Speak with Dr Melsom about whether REGENETEN is appropriate for your shoulder.
Recovery and outcomes
Most patients achieve substantial pain relief and good return of function. The repair’s success depends on tear size, tendon quality and adherence to the rehabilitation program — which is why the therapy after surgery matters as much as the surgery itself.