Failed Rotator Cuff Repair: What Happens Next?
Experiencing a failed rotator cuff repair (an unsuccessful surgical attempt to reattach or repair torn shoulder tendons) can be distressing. Understand why these surgeries sometimes fail, your treatment options, and how to achieve the best possible recovery.
What is a Failed Rotator Cuff Repair?
A failed rotator cuff repair occurs when the surgical procedure to fix torn tendons in the shoulder does not heal correctly or relieve symptoms. Patients typically notice persistent pain, weakness, and limited shoulder movement despite initial surgery.
*”Common Causes of Failure
Rotator cuff repairs may fail for several reasons:
- Tendon re-tear: The tendon pulls away from the bone again.
- Poor tissue quality: Age-related tendon degeneration can reduce healing capacity.
- Inadequate healing environment: Smoking, diabetes, and poor circulation affect recovery.
- Incorrect surgical technique: Inappropriate procedure or inadequate fixation during initial surgery.
- Early overuse: Too much physical strain soon after surgery.
Recognising a Failed Repair
Typical signs of a failed rotator cuff repair include:
- Persistent or increasing pain after surgery
- Difficulty lifting the arm above shoulder height
- Ongoing weakness in the affected shoulder
- Clicking or popping sensations during shoulder movement
If symptoms persist more than three months after surgery, seek specialist evaluation.
Diagnostic Steps
If a failed repair is suspected, your specialist may recommend:
- Clinical examination: Assessing shoulder strength and movement limitations.
- Imaging studies: MRI scans or ultrasound to confirm a re-tear or incomplete healing.
- X-rays: Checking for additional issues like arthritis or bone spurs.
Treatment Options for Failed Repairs
Managing a failed repair depends on your age, overall health, tendon quality, and personal goals:
- Revision Surgery: A second surgical procedure attempting to repair the tear, usually with advanced techniques like tendon transfers or grafts.
- Non-surgical management: Physiotherapy, pain management, steroid injections, and activity modification.
- Alternative Surgical Options: Procedures like reverse shoulder replacement in cases of severe tendon damage and arthritis.
Surgical Considerations
Revision rotator cuff repairs are more complex and require a tailored approach. Advanced techniques include:
- Tendon transfer surgery: Using healthy nearby tendons (such as the latissimus dorsi) to replace severely damaged ones.
- Biological enhancements: Platelet-rich plasma (PRP) or biological scaffolds to improve healing.
- Augmented fixation: Specialised anchors and implants for stronger tendon attachment.
Clinical Pearls / Key Points
- Up to 20% of rotator cuff repairs fail to heal effectively, often due to tendon quality or patient-specific factors.
- Timely diagnosis and management of a failed repair improve outcomes significantly.
- Revision surgeries are complex and should be performed by specialist surgeons experienced in treating failed repairs.
Patient FAQs
What happens if my rotator cuff repair fails?
If your repair fails, symptoms like pain, weakness, and limited movement persist. You may need additional treatments like physiotherapy, pain relief, or revision surgery.
Can a failed rotator cuff repair heal without further surgery?
Sometimes, non-surgical treatments (like physiotherapy or injections) can help manage symptoms effectively. However, revision surgery may be recommended for better long-term results.
What increases the risk of repair failure?
Factors include older age, smoking, diabetes, large or chronic tears, and early shoulder overuse following surgery.
Is a second surgery more complicated?
Revision surgery is more complex because of scar tissue, weaker tendons, or bone damage from previous surgeries. It requires specialised surgical experience and techniques.
Call-to-Action
For expert evaluation and advice on managing a failed rotator cuff repair, contact The Arm Doc. To book an appointment, phone 020 3384 5588 or email Info@TheArmDoc.co.uk.
For more information and shoulder-care resources, visit www.TheArmDoc.co.uk.
Disclaimer
The information on this page is educational and not a substitute for personalised medical advice. Consult your doctor for specific guidance on your shoulder condition and treatment.