|
Robert U Hartzler1, John W Sperling1, Cathy D Schleck2, Robert H Cofield1
1 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA
Correspondence Address:
Robert H Cofield
Department of Orthopedic Surgery, 200 First Street, SW, Rochester MN 55905
USA
 Source of Support: None, Conflict of Interest: Dr. Cofield receives royalties
from Smith/Nephew and DJO.  | 4 |
DOI: 10.4103/0973-6042.114221
Purpose: Historically, results of open revision of rotator cuff repair have been mixed and often poor. We reviewed the outcomes of revision rotator cuff repair with a detailed analysis of clinical and radiographic risk factors in order to improve patient selection for this type of surgery.
Materials and Methods: Thirty-six patients (37 shoulders) underwent first-time, open revision rotator cuff repair between 1995 and 2005. Average follow-up was 7.0 years (range 1-14.9 years). The tear size was small in 1 shoulder, medium in 8, large in 22 and massive in 6. Associations of 29 clinical and radiographic factors with the outcomes of pain, motion, and function were assessed.
Results: Satisfactory outcome occurred in 22 shoulders (59%): An excellent result in 2, a good result in 7, and a fair result in 13. Unsatisfactory, poor results occurred in 15. Pain was substantially reduced in 25 (68%). Median pain scores decreased to five from a pre-operative eight ( P = 0.002). Median motion did not change from pre-operative to post-operative. The chance of a satisfactory outcome and improved post-operative motion were associated with males, greater pre-operative motion, increased acromial humeral distance, the absence of glenohumeral arthritis, or a degenerative re-tear.
Conclusions: Revision rotator cuff repair, although a safe operation, with a low re-operative rate, has very mixed overall results. By knowing the factors associated with success, surgeons can better counsel patients and with this increased knowledge, consider alternative treatment choices.
[FULL TEXT] [PDF]*
|
Search Pubmed for
