The risk of retearing the rotator cuff after surgical repair

A rerupture of the rotator cuff (RC) is the most frequent complication of repair surgery. Failure rates of surgical repair between 20% and 94% have been reported in the literature. Classically, a large number of factors that can affect RC healing have been described. Factors that can negatively affect outcomes include older age, greater size of original tear, tendon delamination, tendon retraction, tissue quality, fatty infiltration, muscular atrophy. Furthermore, several clinical features that are frequently ignored, such as osteoporosis, diabetes, smoking, and hyperlipidemia, have proven to have equal or more influence on rotator cuff healing than preoperative tendon imaging characteristics.

RC retears occur primarily within 3 months after surgery, with a minority of cases occurring between 3 and 12 months. Once this period passes, the structural results appear to persist over time, as observed in 10-year follow-ups. Magnetic resonance imaging (MRI) and musculoskeletal ultrasound (MSKUS) are the preferred tools for diagnosing RC tears and reruptures.

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