Repair Integrity in Patients Returning for an Unscheduled Visit After Arthroscopic Rotator Cuff Repair: Retorn or Not?

Abstract

Background:After rotator cuff repair, some patients have ongoing problems significant enough to warrant presentation to a clinic for reassessment.Purpose/Hypothesis:The purpose of this study was to determine whether this cohort of patients was more likely to have a healed rotator cuff. We hypothesized that patients who had an unscheduled postoperative visit were more likely to have a healed rotator cuff than those who did not have an unscheduled postoperative visit.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 321 consecutive patients who underwent arthroscopic rotator cuff repair were evaluated; of these, 50 patients had an unscheduled return to clinic that included an ultrasound assessment of the cuff repair within 4 months postoperatively. Repair integrity was evaluated in all patients at 6 months postoperatively via ultrasonography.Results:The failure-to-heal rate was greater in patients who had an unscheduled assessment (8/50; 16%) than in those who did not (14/275; 5%) (P = .01). The patients most likely to have a repair failure were those who were assessed before 2 weeks and after 12 weeks (7/18; 39%) compared with those who were assessed between 3 and 12 weeks (1/32; 3%) (P = .001). The failure-to-heal rate was very low in patients who had an unscheduled assessment with a tear size smaller than 4 cm2 (0/34; 0%) compared with those with tear sizes greater than 4 cm2 (8/16; 50%) (P < .0001, Fisher exact text).Conclusion:Patients who had an unscheduled clinic visit after rotator cuff repair had a 16% chance of a failed healing response, whereas those who did not have an unscheduled visit had a 5% rate of failed healing. The risk of a failed healing response was greater if the tear was larger than 4 cm2, if patients presented within 2 weeks following surgery, or if they presented after 12 weeks postsurgery.

Long-term clinical outcomes of arthroscopic supraspinatus tendon repair using the single anchor tension band technique - Minimum 5-years follow-up

“…However, multiple studies have shown that for small and medium size tears the re-tear rate is low and does not affect patient reported clinical outcomes. 27 Thirdly, this study had few tears fixed with this technique which were greater than 2 cm overall. Additionally, only survey follow-up was obtained on patients after a minimum of 5 years post-operatively, which limits analysis.…”

Prognostic factors for improvement of shoulder function after arthroscopic rotator cuff repair: a systematic review

“…We excluded two recent studies including patients with revision repairs or nonoperative treatment. 5 , 24 Screening of the titles and abstracts of cited and citing references of included records and 18 topical records 7 , 8 , 9 , 15 , 23 , 24 , 26 , 30 , 35 , 40 , 42 , 55 , 58 , 60 , 70 , 71 , 72 , 73 did not yield any additional studies that met our inclusion criteria. A full description of included studies (studied population, outcomes, statistical analyses, and reported effect estimates) is available in Supplemental Tables 1-3 .…”