I don't know why because I didn't do anything that I can remember, but I've retorn my previously repaired rotator cuff. I didn't even know it happened. I went for a follow-up visit and that's what the surgeon told me. How often does this happen? Why does it happen? And what can be done about it?
Studies suggest that up to one-quarter of all patients with a surgically repaired rotator cuff tear will retear it early after the first surgery. The reasons for this aren't entirely clear. It doesn't seem to be linked with how the surgery was done (e.g., mini-open repair versus all-arthroscopically repaired).
It may have something to do with the patient disregarding doctor's orders and doing too much too soon. Young athletes eager to get back in the game and return to competitive sports may fall into this group.
The availability of improved ultrasound images makes it easier than ever to reassess the status of a rotator cuff repair and monitor healing responses. Ultrasound is a quick and inexpensive way to see if a tear has occurred. And it can be used to see how the tear is changing -- either healing itself or getting larger (and by how much)..
One study from the Sports Medicine and Shoulder Service associated with a hospital for special surgery in New York City followed patients with a retorn rotator cuff repair. None of the patients had the tear repaired. The idea was to see what happened over time without intervention.
They found that in a group of 15 patients, the tears got worse with each year. And the larger the tear, the more loss of muscle strength there was. This loss of strength didn't seem to bother the patients. They weren't having pain and they were older (less active with fewer demands on the shoulder).
The bottom line from that study was that retears without repair still provided patients with significant benefit. There was satisfactory pain relief. And despite ultrasound images showing an increase in the size of the tear over time (which was accompanied by a loss of muscle strength), the patients didn't seem to be adversely affected.
Your surgeon will be able to advise you as to the next step. Depending on your symptoms (pain, weakness, loss of function) or lack of symptoms, you may be told to get rechecked periodically to keep an eye on the situation. There is the option of another surgery but without evidence that this is required or necessary for satisfactory long-term results, it's not routinely recommended.
Christopher C. Dodson, MD, et al. The Long-Term Outcome of Recurrent Defects After Rotator Cuff Repair. In The American Journal of Sports Medicine. January 2010. Vol. 38. No. 1. Pp. 35-39.
*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.