Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I'm really disappointed in the results of my arthroscopic rotator cuff repair. I had all kinds of high hopes of being back on the tennis court and golf course by this summer. Instead, all I have to show for the surgery is more shoulder pain and even less motion than before surgery. The surgeon says it's called failed rotator cuff syndrome. What the heck does THAT mean?

Answer:

Normally, arthroscopic repair of the rotator cuff is a very reliable technique. Most patients (more than 90 per cent) swear by it and would do it again if they had to make the decision over. But in the remaining few (six to eight per cent), the repaired tendon fails to heal. Or in some cases, the patient reinjures the arm before healing takes place. These cases are called failed rotator cuff syndrome. The result is as you described yourself: you don't get the expected results. And instead of pain relief, increased shoulder motion, and restored function, there is persistent pain and/or weakness. Some of the reasons patients fail to heal include age (65 years old and older), the tear was very large in size, significant muscle atrophy (wasting), and tendon retraction (tendon pulls way back from the bone). A few other factors that hinder healing after rotator cuff tear repair include smoking, diabetes, unwillingness to engage in the rehab program, and failure to follow the physician's or physical therapist's guidelines during recovery. Treatment for failed rotator cuff syndrome varies depending on the reason(s) why the surgery wasn't successful in the first place. A three-month trial of physical therapy aided by a home exercise program may be all that's needed. But if this measure fails to restore motion and strength, then revision surgery is a possibility. Talk with your surgeon a bit more and find out what he or she thinks might be the reason or reasons for the failed surgery. Sometimes it's not a simple 'this' or 'that' reason. It could be multifactorial (many reasons combined together). If there is a known factor or factors, you might feel more at ease with this disappointing outcome. And the next step in treatment will depend on the reasons for failure. Eric J. Strauss, MD, et al. Management of Failed Arthroscopic Rotator Cuff Repair. In Journal of the American Academy of Orthopaedic Surgeons. May 2012. Vol. 20. No. 5. Pp. 301-309.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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