Been discussed to death on threads like this. Do some research and you will find an increasing list of informed surgeons who are beginning to use ATI to compliment their surgery - sorry if I are appear combative, but that statement pretty ignorant of the numerous ways rotator cuff tears present and are treated by Orthopedic surgeons.
Lets say a patient has a full supraspinatus tear (supraspinatus the most common rotator cuff tendon tear). ATI injection on its own ain't doing jack. It can't force the separated tendon back together. However, knowing the very poor efficacy in surgical repairs, I am personally going straight to St Vincents and having a surgeon there do the repair, knowing he augments his surgeries with ATI to improve recovery and overall end results. I am also asking him for CelGro Tendon too, but you are focusing on ATI, so I digress.
Similarly, if I have an instra-substance tear of the Supraspinatus (a partial tear not a full rupture), unless its a big one, any decent conservative surgeon is likely first to recommend physiotherapy and a light but progressive bio-mechanical load regime and strengthening of surrounding muscles and tendon rather than surgery immediately. A well informed surgeon is going to actually going to recommend ATI to regenerate and repair the partial tear at a micro-biological level that will eventually likely not even show as a tear under MRI. Thus the patient less likely to face invasive surgery down the line for a degenerative tear that otherwise likely eventually worsens.
You are quite correct, many Surgeons absolutely will be against it. Those Surgeons are frankly the ignorant ones with very poor perspective, the ones who will not admit to you that when they open you up the tendon wasn't even fully torn, and you perhaps didn't actually need the surgery that is only successful, because it wasn't actually necessary (a lot of studies showing torn tendons under MRI, were not fully torn at all on advent of surgery), but see you in 12 months of discomfort and relative morbidity.
"How do you get round that one?" Education. Removal of ignorance amongst patients and Physicians. Increasing acceptance of regenerative medicine and knowledge of the poor efficacy of invasive and often unnecessary surgeries.
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