Early revision rotator cuff repair: an analysis of outcomes and function.
European Journal of Orthopaedic Surgery & Traumatology
PURPOSE: Rotator cuff repair (RCR) is commonly performed and can have good functional outcomes. However, failure of RCR surgery can be challenging for both patient and surgeon alike. This study examines the outcomes of early revision RCR for the management of clinically failed RCRs.
METHODS: Thirty-six patients undergoing revision RCR within 1 year of primary surgery were evaluated. Range of motion (ROM) and patient-reported outcomes (PROMs) were assessed at baseline, post-primary RCR, and post-revision RCR.
RESULTS: Patients with a documented repair failure after primary RCR failed to improve in both ROM and PROMs compared to before primary RCR. Following early revision, RCR SANE (p = 0.024, p < 0.001), ASES (p = 0.004, p < 0.001), and SST (p < 0.001, p = 0.001) scores improved significantly compared to pre-primary and pre-revision scores, respectively. Documentation of a new traumatic injury did not affect clinical or functional outcomes compared to atraumatic re-tears. Number of tendons torn was positively correlated with higher SANE scores (r = 0.638, p = 0.008) and negatively correlated with SST score (r = -0.475, p = 0.03) and improvement in forward elevation (r = -0.368, p = 0.03) after primary RCR. There were significant correlations between number of tendons torn and improvement in SANE (r = 0.664, p = 0.007) and ASES scores (r = 0.468, p = 0.043) from post-primary RCR to post-revision RCR.
CONCLUSION: Early revision after failed RCR can lead to clinically significant improvement in functional outcomes. The presence of a traumatic re-injury does not appear to affect revision RCR outcomes as it does in the primary setting. Patients with early clinical failures of primary RCR may benefit from early revision RCR.
LEVEL OF EVIDENCE: III: Retrospective Case Series.
Online ahead of print
Monir JG, Astolfi MM, Sholder D, Kocovic N, Horneff JG 3rd, Abboud JA, et al Early revision rotator cuff repair: an analysis of outcomes and function. Eur J Orthop Surg Traumatol. 2022 Jan 22. doi: 10.1007/s00590-021-03182-y. Epub ahead of print. PMID: 35064337.