Revision Arthroscopic Rotator Cuff Repair: A Prospective Study (SS-13)

Abstract

Introduction We examined the results of revision arthroscopic rotator cuff repairs in a prospective series performed at a single institution. Methods A prospective case series was conducted of revision arthroscopic rotator cuff repairs performed at our institution, from January 1, 2004, to July 1, 2007. Both the index surgery and revision surgeries had to have been carried out at our institution for inclusion in the study. Magnetic resonance imaging (MRI) confirmation of all index tears and subsequent tears were documented prior to surgery. Prospective data collection was obtained preoperatively and postoperatively at 1 week, 6 weeks, 3 months, 6 months and annually thereafter. All patients were evaluated preoperatively and postoperatively using the Constant-Murley shoulder scoring system. Patient demographics were recorded, as were tear size, selected risk factors (tobacco use, workers' compensation, and diabetes), and physical examination. Results There were 2356 rotator cuff repairs at our institution during this time period. Seventy-eight of these patients underwent revision repair. Nine patients were excluded due to lack of adequate follow-up. This left 75 revision arthroscopic rotator cuff repairs in 69 patients available for review. Thirty males and 39 females with a mean age of 53 years (29-78 years) were followed for a mean of 36 months (24-70 months). The revision repair time interval varied from 3 weeks to 55 months (mean 9.7 months). At the time of revision surgery there were 35 small tears, 11 medium tears, 17 large tears, and 12 massive tears identified. In only eight of the revision cases was the rotator cuff tear larger than the index tear. Overall, no statistical difference was found between rotator cuff tear size at the index procedure and at revision surgery (p Conclusion Revision arthroscopic rotator cuff repair resulted in 67% good or excellent outcomes with significant improvement in motion and function as demonstrated by the Constant-Murley shoulder score. Those patients with combined risk factors had poorer functional outcomes. Our review demonstrates that overall shoulder function and symptoms do significantly improve after arthroscopic revision rotator cuff repair.