Question:I'm so frustrated because my rotator cuff repair didn't hold. I don't know if I should bother having the surgery done again or not. What do you advise?
Answer:There are many reasons why rotator cuff repairs fail. Knowing the mode of failure helps the surgeon determine what should be done. Did the sutures fail to hold? Where did the failure occur (tendon, bone)?
Comparing the mode of failure with the type of repair is the next factor. Did the surgeon use the three-suture or the multi-suture method? And how much of a failure occurred?
Usually failure of the cuff repair is measured by the separation of the tendon repair site. A five-millimeter (or more) gap is a partial failure. More than a 10-millimiter gap at the repair site suggests a total failure.
Bone density is another key factor. Tunnels are drilled through the bone and the sutures threaded through the tunnels. The sutures can pull through the bone if the bone density isn't strong enough or there isn't enough bone mass.
At your next appointment with the surgeon, ask for a review of what happened. Find out what your options are and your surgeon's recommendation. Your decision will be influenced in part by your age, activity level, and occupation.James Bicos, MD, et al. The Multi-Suture Technique for Rotator Cuff Repair: A Biomechanical Evaluation. In Orthopedics. November 2007. Vol. 30. No. 11. Pp. 910-919.
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