Rotator cuff repairs typically produce very good results.
Unfortunately, as with any operation, some patients do not have a successful
outcome. Occasionally patients will have
an unsuccessful repair that does not heal and continue to have pain after
surgery. Sometimes the pain is even worse than before! What can be done for
people who have had a failed rotator cuff repair?
These patients are often the most rewarding to treat, and as
a shoulder specialist I see many of these individuals for second opinions. Over
the past week I have treated three patients with failed rotator cuff repairs
who each had very different problems. Together they illustrate the point that
each patient is unique, and in order to provide good care we must tailor our
treatment to the individual’s problem.
Patient #1: 70 year old man who had a large rotator cuff
tear that had been previously repaired and re-tore. He was now in severe pain
and could not raise the arm in the air. His
MRI showed a massive rotator cuff tear that could not be fixed. We performed a
reverse shoulder replacement, which is a specialized type of shoulder
replacement that can be used to treat massive rotator cuff tears in older
patients.
 |
| A reverse shoulder replacement |
Patient #2: This active woman had a prior rotator cuff
repair one year ago. Unfortunately she continued to have pain and stiffness. We
performed an arthroscopic surgery to clean out scar tissue. We found that she
had a re-tear of her rotator cuff that we were able to re-fix
arthroscopically.
 |
| Re-tear of rotator cuff. |
 |
| Successful revision repair |
Patient #3: This young woman had a massive rotator cuff
tear. She had a prior arthroscopic surgery by a highly skilled surgeon who
found that her tear was not fixable. She
was referred to me for a lattissimus muscle transfer procedures. During
this operation a muscle is moved from the back and attached to the shoulder to
take the place of the torn rotator cuff. This operation is appropriate for young
patient with massive tears that can't be fixed.
These three patients all had a failed rotator cuff repair,
but their problems were very different. In order to provide the best possible
care we needed to understand their age, activity level, and type of tear.
If you would like a second opinion for a failed rotator cuff
repair, please contact
Dr. Carofino at carofinob@atlanticortho.com.
