Long-term outcomes of revision arthroscopic rotator cuff repair surgery is not as successful as in a first-time surgery, according to researchers from the Orthopaedic Research Institute in Sydney, Australia, who presented their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day.
"According to our results, patients with revision arthroscopic rotator cuff surgery had gained short term (six months post operatively) functional and clinical improvements. However, these gains pretty much disappeared by two years following surgery," said lead researcher, Aminudin Mohamed Shamsudin, MD, M.Medicine (Ortho) from the Orthopaedic Research Institute in Sydney, Australia.
Shamsudin and his team analyzed and followed-up with 360 arthroscopic rotator cuff surgery patients where they compared the functional and clinical outcomes of 310 primary cases with that of 50 revision cases. The revision group patients were older with a mean age of 63 while the primary group patients had a mean age of 60. The primary group also had a larger rotator cuff tear on average. Two years after surgery the primary group reported less pain at rest, during sleep and with overhead activity compared to the revision group. At two years, the primary group also had better forward flexion, abduction, internal rotation and strength compared to the revision group. The re-tear rate for the primary rotator cuff repair was 16 percent at six months and 21 percent at two years. The re-tear rate for the revision rotator cuff repair was 28 percent at six months and 40 percent at two years. The increase in re-tear rate in the revision group at two years was associated with increased pain, impaired overhead function and less overall satisfaction with shoulder function.
"Further studies are needed to identify ways to improve long-term outcomes following revision arthroscopic rotator cuff surgery. However, our results do highlight the long-term success of primary rotator cuff surgery and may help patients understand the realistic expectation of the outcomes of revision arthroscopic rotator cuff surgeries," said Shamsudin.