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Results of a second attempt at surgical repair of a failed initial rotator-cuff repair.
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1984
Year
Twenty-seven PatientsActive AbductionPain MedicineSecond AttemptSurgical RepairOrthopaedicsRotator CuffSurgeryPain ManagementRotator Cuff RepairArthroscopic TechniqueMedicineOrthopaedic SurgeryShoulder GirdleShoulder SurgeryPhysical TherapyHealth Sciences
Failure of the initial rotator‑cuff repair is associated with massive or large tendon tears, deltoid origin damage, and possibly inadequate postoperative external support. Twenty‑seven patients with failed initial repairs underwent a second surgical attempt, and 20 of them were followed for at least two years (average 48 months), with 17 examined at an average of 46 months post‑surgery. Among these patients, 7 required a third operation, 16 of 21 reported substantial pain relief, but only 7 of 20 shoulders gained more than 30° of active abduction, 19 remained weak, and the overall outcome distribution was 17% good, 25% fair, and 58% poor, indicating limited functional benefit and advising caution for a second repair.
Twenty-seven patients with twenty-seven involved shoulders underwent a second attempt at repair of an initial rotator-cuff repair that had failed. Factors associated with the failure of the initial repair included a massive or large tendon tear, damage to the deltoid origin at the original surgery, and possibly inadequate postoperative external support. Seven patients required a third operation because of continuing pain or weakness. The remaining twenty patients were followed for a minimum of two years (average, forty-eight months) and seventeen of them were examined at an average of forty-six months (range, twenty-six to 118 months) after surgery. Postoperatively, although seventeen patients (63 per cent) still had moderate or severe pain, sixteen (76 per cent) of the twenty-one patients who were operated on to relieve pain reported that the pain was substantially diminished. Active abduction increased an average of 8 degrees, but only seven shoulders gained more than 30 degrees of active abduction. Nineteen shoulders remained moderately or markedly weak in abduction. Over-all, four patients (17 per cent) had a good result; six (25 per cent), a fair result; and fourteen (58 per cent), a poor result. These results suggest that the surgeon should be quite hesitant to propose a second attempt at rotator cuff repair to a patient, as although pain may be diminished, active movement is unlikely to improve.