New Retear Pattern after Rotator Cuff Repair at Previous Intact Portion of Rotator Cuff

Abstract

Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope. While successful outcomes of patients treated by arthroscopic rotator cuff repair have been reported by virtue of recent advances in arthroscopic techniques and their instrumentation, overall rates of retear from 21% to 26% were reported in patients after rotator cuff repair according to the repair technique. 1)Retear patterns after arthroscopic rotator cuff repair can be classified into two patterns according to the retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method.2) This classification is widely used to differentiate retear type after rotator cuff repair. These retear patterns might be caused by a mismatch on the tension applied on the tendon. However, not all retears of the rotator cuff were applicable to this classification.3) Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging (MRI) in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope. Case ReportCase 1A 60-year-old female patient presented continuous pain in the right shoulder for 2 months. In her previous history, she had undergone rotator cuff repair of the right shoulder for a mediumsized suprasupinatus tear (2×2 cm size, crescent type) by the arthroscopic suture bridge technique 3 years ago in this clinic. Two medial suture anchors and two lateral suture anchors were used for the arthroscopic suture bridge technique. Torn cuff tendon was repaired with slightly anteriorly weighted tension to restore the foot print without excessive tension. The patient showed improved symptoms after the operation. She repeatedly practiced yoga beyond the normal range of motion of the shoulder with a yoga trainer. Without any special traumatic event, symptoms gradually worsened. Routine serial ultrasonography revealed that the repaired cuff maintained normal thickness until 1 year

Rotator cuff retear after repair surgery: comparison between experienced and inexperienced surgeons

“…In accordance with Cho et al [ 12 ], the retear pattern was classified as type 1 when no rotator cuff tissue was visible in the rotator cuff footprint and as type 2 when remnant cuff tissue was present. The retear was classified as “extra only” if the retear did not affect the previous surgical area [ 13 ].…”

The effect of exercise types for rotator cuff repair patients on activities of shoulder muscles and upper limb disability

“…Also, it has both stability and mobility1 ) . Rotator cuff muscles facilitate smooth motions, performing abduction, and rotation, and generates compressive force in the glenohumeral joint2 ) , Mechanical damage of the rotator cuff muscles can be shown by characteristics such as displacement of the shoulder joint, rotation, formation, tendon sprain, tendon movement, fluid outflow, and failure of energy conservation3 ) . It is reported that tendon rupture of the supraspinatus has the highest incidence among rotator cuff muscle injuries4 ) .…”