With advances in arthroscopic surgery, excellent results have been reported after primary arthroscopic repair of rotator cuff tears approaching or even surpassing those of open repair. Outcomes after revision surgery, however, have received much less attention, with existing reports almost exclusively describing the results after open revision techniques. Among this small group of studies, outcomes are generally worse than after primary repair, with the majority of patients reporting fairly predictable pain relief but inconsistent and often minimal functional gains.
Despite the theoretical benefits of arthroscopically approaching revision cases, including improved visualization and classification of tear configuration and size, appreciation of previously unrecognized joint lesions, minimization of deltoid disruption, and decreased risk of postoperative stiffiness, we are aware of only 2 reports documenting the results of arthroscopic revision rotator cuff surgery. Lo and Burkhart reported a single-surgeon experience with 14 consecutive cases revised arthroscopically and evaluated at a minimum of 1 year postoperatively (mean, 23 months). The majority of these tears (11 of 14) were classified as massive, 4 of which could only be repaired partially. After surgery, these authors reported significant improvements in active motion and University of California at Los Angeles scores, with 64% of outcomes classified as good to excellent, a finding that is comparable to those reported for open techniques. More recently, Trantalis reported a single-surgeon case series of 5 patients who demonstrated medial row failure after arthroscopic double-row rotator cuff repair and subsequently underwent arthroscopic revision rotator cuff repair. Although validated shoulder outcome scores were not employed, the authors noted that 4 of 5 patients had some improvement in symptoms at a mean follow-up of 26.4 months.
The purpose of our study was to report functional outcomes after arthroscopic revision rotator cuff repair and to identify prognostic factors that may predict attributes associated with failure of arthroscopic revision rotator cuff repair.
Full Article: Outcomes After Arthroscopic Revision Rotator Cuff Repair