Medium-term outcomes of a cohort of revision rotator cuff repairs

J Shoulder Elbow Surg. 2020 Jul;29(7):1346-1352. doi: 10.1016/j.jse.2019.12.011. Epub 2020 Mar 4.

Abstract

Background: There are limited medium- and long-term studies investigating clinical outcomes following revision rotator cuff surgery. The aim of the current study was to analyze the medium-term pain and functional outcomes of a cohort of revision rotator cuff repairs.

Methods: This was a multicenter, prospective cohort study of revision rotator cuff repairs undertaken between March 2009 and December 2010. Pain, function (Flex-SF), and postoperative data were collected at baseline; 6, 12, and 24 months; and 5 years.

Results: A total of 125 revision rotator cuff repairs were included in this study. Average improvement in Flex-SF and pain from baseline to 5 years was 8.5 (P < .001) and 2.1 points, respectively (P < .001). The improvement was not as pronounced as those who underwent primary repair. Significantly lower pain scores were seen in nonsmokers (P < .001) and in those who underwent tenotomy rather than tenodesis (2 vs. 3.5, P < .05) for a damaged long head of biceps. Significantly higher function scores were seen in those with only 1 tendon involved (P < .05). The patient-reported retear rate was 32.6%, and the reoperation rate was 34.7%.

Conclusion: Revision rotator cuff repair provides significant improvement in both pain and function at 5 years postoperation, though not as good as primary repair. Superior clinical outcomes are seen in nonsmokers, those with only 1 tendon affected, and those who undergo tenotomy instead of tenodesis for a damaged long head of biceps tendon.

Keywords: Orthopedic surgery; outcomes; prognostic factor; revision; rotator cuff; shoulder.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Arthroplasty*
  • Arthroscopy*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / surgery
  • Plastic Surgery Procedures
  • Recovery of Function
  • Reoperation
  • Rotator Cuff Injuries / surgery*
  • Tenodesis*
  • Tenotomy*
  • Treatment Outcome