Complications after arthroscopic revision rotator cuff repair

Abstract

Purpose: The purpose of this study was to determine the complication rate of arthroscopic revision rotator cuff repair (ARRCR).

Methods: The retrospective review included 94 patients who underwent ARRCR performed by the 2 senior authors between January 2000 and June 2009 (mean age, 52 years; age range, 44 to 72 years). Sixty-four patients underwent 1 revision rotator cuff repair, 23 patients underwent 2 revisions, and 7 patients underwent 3 or more revisions. The rotator cuff tear at the time of the revision was characterized as massive (>5 cm) in 51 patients (54%), large (>3 to 5 cm) in 14 patients (15%), medium (1 to 3 cm) in 17 patients (18%), and small (<1 cm) in 12 patients (13%). There was a single-tendon tear in 12 patients (13%), 2 tears in 31 patients (33%), and 3 or 4 tears in 51 patients (54%). Additional procedures included revision acromioplasty (n = 66), distal clavicular excision (n = 19), biceps tenodesis (n = 52), suprascapular nerve release (n = 14), and loose anchor removal (n = 6).

Results: Complications developed in 19 patients (20.2%) within 1 year of undergoing ARRCR. The complications included failure to heal (10.6%, n = 10), stiffness (7.4%, n = 7), infection (2.1%, n = 2), and nerve injury (1.1%, n = 1). A direct correlation was found between the complication rate and the number of revision surgeries: 14% after 1 revision, 17.4% after 2 revisions, 33% after 3 revisions, and 50% after 4 or more revisions. The minimum follow-up of all the patients in this study was 1 year. We continued to follow up every patient who was diagnosed with complications during this year until resolution of the complication, or we are still continuing to perform follow-up of these patients.

Conclusions: The complication rate after ARRCR is about twice the published rate for primary rotator cuff repair. There is a direct correlation between the complication rate and the number of revision surgeries. The most common complication recognized was failure to heal because of poor tissue quality.

Level of evidence: Level IV, therapeutic case series.