Factors affecting outcome after structural failure of repaired rotator cuff tears

• Published in: Journal of bone and joint surgery. American volume Vol. 96; no. 2; p. 99
• Main Authors: Namdari, Surena, Donegan, Ryan P, Chamberlain, Aaron M, Galatz, Leesa M, Yamaguchi, Ken, Keener, Jay D
• Format: Journal Article
• Language: English
• Published: United States 15.01.2014
• Subjects: Age Factors; Aged; Arthroscopy - adverse effects; Arthroscopy - methods; Cohort Studies; Disability Evaluation; Female; Follow-Up Studies; Humans; Injury Severity Score; Male; Middle Aged; Occupations; Pain Measurement; Range of Motion, Articular - physiology; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - methods; Retrospective Studies; Risk Factors; Rotator Cuff - diagnostic imaging; Rotator Cuff - surgery; Rotator Cuff Injuries; Sex Factors; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Tendon Injuries - diagnostic imaging; Tendon Injuries - surgery; Tomography, X-Ray Computed - methods; Treatment Failure
• ISSN: 1535-1386
• DOI: 10.2106/JBJS.M.00551

Failure of structural healing is not infrequent after rotator cuff repair and often is not associated with clinical outcome. The goals of this study are to describe outcomes in a cohort of patients with a failed rotator cuff repair and to evaluate factors associated with clinical outcome. This was a retrospective study of all patients with failure of structural integrity after rotator cuff surgical repair. A threshold American Shoulder and Elbow Surgeons (ASES) score of 80 points was used to allocate patients into either the successful (≥80 points; Group 1) or unsuccessful (<80 points; Group 2) cohorts. Demographics, patient-centered instruments for shoulder function, radiographic parameters, and shoulder motion were compared between groups. On the basis of the postoperative ASES score, thirty-three patients (54.1%) were included in Group 1 and twenty-eight patients (45.9%) were included in Group 2. Fifteen patients (53.6%) in Group 2 reported a labor-intensive occupation compared with two patients (6.1%) in Group 1 (p < 0.001). Multiple regression analysis demonstrated that labor-intensive occupation (odds ratio [OR], 202.3; p = 0.026), preoperative Simple Shoulder Test (SST) score (OR, 0.50; p = 0.028), and preoperative external rotation (OR, 0.91; p = 0.027) were associated with inclusion in Group 2. Age and other demographic variables, including sex, dominant-sided surgery, and medical comorbidities, were similar for the groups. Successful outcomes were achieved in 54% of patients with failed rotator cuff repair. Those who self-identified their occupation as being labor-intensive represented a special group of patients who are at high risk for a poor outcome after a failed rotator cuff repair.