Failed rotator cuff surgery: what can we do?

摘要

Failure after rotator cuff surgery represents a difficult and challenging problem. Patients may complain of persistent pain, stiffness, weakness or loss of function, usually loss of active anterior elevation, but often loss of active external rotation, with impairment in activities of daily living. Patients with pain and preserved function often are adequately treated with physiotherapy, steroid injection, or procedures such as repair for a reparable tear, debridement, biceps tenotomy or tenodesis, partial repair or tendon transfers for irreparable tears, or hemiarthroplasty in the presence of glenohumeral arthritis. However, patients with loss of function often are not adequately treated by any of these methods and often require a reverse shoulder arthroplasty, which can improve function in selected patients. However, results are lower than primary surgery, with a higher complication rate. As experience and technology continue to advance, newer treatment options may offer further promise for this challenging patient population.