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Early revision rotator cuff repair: an analysis of outcomes and function

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

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.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Florida, Gainesville, FL, USA

    Joseph G. Monir

  2. Department of Orthopaedics, Beaumont Royal Oak Hospital, Royal Oak, MI, USA

    Matthew M. Astolfi

  3. The Rothman Institute, Philadelphia, PA, USA

    Daniel Sholder & Joseph A. Abboud

  4. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Nikola Kocovic

  5. Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA

    J. Gabriel Horneff III

  6. Department of Orthopedics, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    Bradley S. Schoch

Authors
  1. Joseph G. Monir
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  2. Matthew M. Astolfi
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  3. Daniel Sholder
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  4. Nikola Kocovic
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  5. J. Gabriel Horneff III
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  6. Joseph A. Abboud
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  7. Bradley S. Schoch
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Corresponding author

Correspondence to Bradley S. Schoch.

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Conflict of interest

Schoch: Exactech: paid consultant, royalties; Horneff: Miami Device Solutions: Paid consultant, Springer Nature: Publishing royalties, financial or material support, Tigon: Unpaid consultant; Abboud: Aevumed: Stock or stock Options, Arthrex, Inc: Research support, Bioventus: Paid consultant, Department of Defense: Research support, DJ Orthopaedics: IP royalties; Paid consultant, Globus Medical: IP royalties; Paid consultant, Integra: Research support, Lima: Research support, Marlin Medical Alliance, LLC: Stock or stock Options, Mid Atlantic Shoulder and Elbow Society, Executive Board and Founder: Board or committee member, OBERD: Stock or stock Options, OREF: Research support, Orthofix, Inc.: Research support, Orthospace: Research support, OsteoCentric Technologies: IP royalties, OTS Medical: Stock or stock Options, Shoulder JAM LLC: Stock or stock Options, SLACK Incorporated: Publishing royalties, financial or material support, Smith & Nephew: IP royalties, Stryker: IP royalties; Paid consultant, Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support, Zimmer: IP royalties; Paid consultant; Research support.

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12D.223.

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Thomas Jefferson University, Office of Human Research, Institutional Review Board, Jefferson Alumni Hall, 1020 Locust St. Suite M-34, Philadelphia PA 19107.

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Monir, J.G., Astolfi, M.M., Sholder, D. et al. Early revision rotator cuff repair: an analysis of outcomes and function. Eur J Orthop Surg Traumatol 33, 321–326 (2023). https://doi.org/10.1007/s00590-021-03182-y

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  • DOI: https://doi.org/10.1007/s00590-021-03182-y

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