One-third (33%) of rotator cuff repairs failed, and 74% of the failures occurred within three months of surgery in a new long-term study of 107 patients.
"Most retears appear to be a failure to heal rather than retearing after healing," Dr. Rainer Kluger, at SMZOst Donauspital in Vienna, Austria, and his team write. "Efforts to improve healing during the first three months post-operatively should be made."
Dr. Kluger's team studied patients who underwent an arthroscopically-assisted mini-open rotator cuff repair, assessing them with at least one magnetic resonance image, plus outcome measures and ultrasonographies at three months, six months, one year and yearly thereafter for an average time of eight years.
Their paper was published online May 24th in the American Journal of Sports Medicine.
The failures that occurred within six months of surgery were not traumatic. Most, 74%, occurred within three months, and 11% occurred between three and six months. The rest were trauma and sports-related, and they occurred between two and five years after surgery.
Multivariate analysis showed that patients whose tendons heal by six months should perform well on shoulder disorder outcome ratings (normalized Constant-Murley Shoulder Outcomes Score) as long as seven years after surgery. The rating systems measure pain, range of motion, strength and the ability to do everyday tasks.
Knowing that healed tendons, or recurrent tears, at six months can predict outcomes at seven years can help caregivers as they counsel patients, the researchers conclude.
Am J Sports Med 2011. Abstract
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