Elsevier

Orthopaedics & Traumatology: Surgery & Research

Review article

Failed rotator cuff repair

Abstract

Later on rotator cuff repair, few patients require revision surgery, and failure to heal does not e'er translate into clinical failure, although healing is associated with amend outcomes. Failure of rotator cuff repair is perceived differently by the patient, by the surgeon, and in terms of social and occupational abilities. The piece of work-upward of failed cuff repair differs little from the standard work-upwardly of cuff tears. Data must be obtained well-nigh the circumstances of the first repair procedure, a possible diagnostic inadequacy and/or technical mistake, and early or delayed trauma such as an ambitious rehabilitation programme. Near gage retears do not crave surgery, given their good clinical tolerance and stable outcomes over time. Repeat cuff repair, when indicated past pain and/or functional impairment, can meliorate pain and office. The quality of the tissues and time from initial to repeat surgery volition influence the outcomes. The ideal candidate for echo repair is a male, younger than 70 years of historic period, who is not seeking bounty, shows more 90̊ of forwards top, and in whom the first repair consisted only in tendon suturing or reattachment. In addition to patient-related factors, the local conditions are of paramount importance in the decision to perform echo surgery, notably echo suturing. The most favourable scenario is a small retear with expert-quality muscles and tendons and no osteoarthritis. When these criteria are not all present, several options deserve consideration as potentially capable of relieving the pain and, to a lesser extent, the functional impairments. They include the implantation of material (autograft, allograft, or substitute), a muscle transfer process, or reverse shoulder arthroplasty. However, the outcomes are poorer than when these options are used as the primary procedure. Prevention is the best handling of cuff repair failure and involves careful patient option and a routine analysis of the treatments that may be required past concomitant lesions. Biceps tenotomy should be considered on a example-by-instance basis. Smoking abeyance should be strongly encouraged and any metabolic disorders associated with repair failure should be brought nether control.

Keywords

Shoulder

Rotator cuff

Failure

Repair

Retear

Revision surgery

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