Recurrent rotator cuff tear: is ultrasound imaging reliable?
These authors point out that " Recurrent rotator cuff tears after rotator cuff repair (RCR) are common and found to be a major cause of postoperative pain. Retear rates are approximated at 7% to 17% for small tears and up to 41% to 94% for large and massive tears. Retears most commonly occur up to 6 months after the operation."
These authors point out that " Recurrent rotator cuff tears after rotator cuff repair (RCR) are common and found to be a major cause of postoperative pain. Retear rates are approximated at 7% to 17% for small tears and up to 41% to 94% for large and massive tears. Retears most commonly occur up to 6 months after the operation."
The aim of their study was to assess the reliability of ultrasonography (US) for the detection of recurrent rotator cuff tears in patients with shoulder pain after RCR.
They retrospectively analyzed the data of 39 patients with an average age of 66 years (range, 39-81 years) with shoulder pain after arthroscopic RCR who had subsequently undergone US, followed by revision arthroscopy.
A failed cuff repair was frequently found among these 39 patients: by US in 21 patients (54%) and by revision arthroscopy in 26 patients (67%).
Comment: This study does not present the rate of rotator cuff repair failure in the overall experience of the authors, but it is impressive that over half of the patients with shoulder pain after a cuff repair attempt had a failed repair. This study also does not present the percentage of patients with a retear that did not have shoulder pain. Both of these bits of information would be helpful in understanding the rate and clinical significance of cuff repair failure.
We are often asked to evaluate patients with pain and weakness after attempted cuff repair. We find that the diagnosis of failed repair is usually evident from the history and physical exam. We are very rarely tempted to try a "re-repair" after a prior repair attempt failure because the tissue quality and quantity are typically inadequate for a robust repair.
For many such cases the greatest value procedure is often a "smooth and move" as described here:
Treatment of irreparable cuff tears with smoothing of the humeroscapular motion interface without acromioplasty
We are often asked to evaluate patients with pain and weakness after attempted cuff repair. We find that the diagnosis of failed repair is usually evident from the history and physical exam. We are very rarely tempted to try a "re-repair" after a prior repair attempt failure because the tissue quality and quantity are typically inadequate for a robust repair.
For many such cases the greatest value procedure is often a "smooth and move" as described here:
Treatment of irreparable cuff tears with smoothing of the humeroscapular motion interface without acromioplasty
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