Rotator cuff tears can be tricky. And unfortunately not all rotator cuff repairs are fool proof. Older studies showed that rotator cuff repairs failed to heal in up to 3/4 of attempts in some patients.
Newer studies tend to show more favorable results but on average still report at least a 1/4 chance of retiring of the rotator cuff repair.
There are many angles to this issue. Not all rotator cuffs that fail to heal actually cause pain for patient. But some do and this is why the issue still matters. So research continues on ways to improve our healing rates – a slow and laborious porcess.
In the interim we are actually getting better at identifying the patients who are at high risk prior to performing repair. This latest study identifies risk factors for patients who have rotator cuff tears and a have a high potential of tearing again after arthroscopic surgery.
Out of 1000 cases, this group of researchers had a 17% failure rate: 174 of their 1000 patients developed a retear ff the rotator cuff tendon after surgery.
They looked at all of these patients and tried to determine if there were differences between the groups that tore their tendon again and the group that healed.
The factors that put patients at higher risk for a failed repair after surgery were: the size of the tear (larger tears retore more often), thickness of the tear (tears that involved the full thickness of the tendon retore more often) and the age of the patient at surgery (on average patients who had retears were 66 years old and ones that healed completely were 58 years old).
None of these findings are earth shattering. We’ve known for some time that one of the biggest predictors for retearing your rotator cuff tendon is the size of the tear. And we have also known that older patients often have higher chances of having rotator cuff tears.
Perhaps more disappointing, none of these factors are very modifiable from a patient perspective: you can’t change the size of your tear, and you usually have little control over when you seek help from your doctor for a rotator cuff tear.
The upside of this information is that we are better able to counsel our patients regarding their risks of a retar after surgery and better guide them through different treatment options prior to making that decision.
Take Home Points for Patients: you can’t change the size of your rotator cuff tear at the point when you are first diagnosed. But if you are diagnosed with one at a younger age and are considering putting off surgery for a number of years, you may be increasing your risk of a failed repair.
Take these statistics into account when you are considering getting a rotator cuff surgery. Even with large tears, the odds of healing your tendon are in your favor, albeit not 100%.