Failed Shoulder Surgery or Rotator Cuff Repair

Rotator cuff repair –either open or arthroscopic– can fail for multiple reasons.  The failure rates among different surgeons have been reported to range from 11% to 94% with surgeon skill and experience cited as one of the many variables involved.  Many other factors including patient related factors such as smoking history, age, size of tear, quality of tissue and compliance (meaning following the restrictions and directions required after surgery to allow healing of the repaired tissue) can also play a part in a failed rotator cuff repair. Our published results for arthroscopic repair of challenging rotator cuff tears are here. We recently also reported on salvage of catastrophic rotator cuff failure.

Reasons for a Failed Rotator Cuff Repair

failed rotator cuff surgeryBecause the reasons for a failed rotator cuff repair can be many and complex, we can’t cover them all.  What is most important is to start with a thorough evaluation and make sure you have as complete a picture as possible regarding the most important factors responsible in your individual case.  After a thorough evaluation, we may recommend additional tests to evaluate the nerve supply to your rotator cuff and the status of the tissues within your shoulder.

The next step is to go over the options for treatment.  If the quality of the rotator cuff tissue is good, we may recommend a revision arthroscopic rotator cuff repair.

Even if the initial repair was performed with an open incision, our specialized techniques and experience allow us to repair these tears arthroscopically.   We may also discuss additional options with you to help improve the chances of healing based on your unique circumstances.

Options for Failed Rotator Cuff Surgery

Another option we may recommend is Arthroscopic Rotator Cuff Repair with Graft Reinforcement.  Much like reinforcing the elbow on a jacket or using a patch to repair a bicycle tire, the patch is applied on top of the rotator cuff repair to help share the load and reduce stress on the rotator cuff during the critical healing period.  Over time, the patch becomes part of the patient’s own tissue hopefully ultimately resulting in a stronger rotator cuff tendon.

2nd rotator cuff surgeryPatch grafts aren’t new and many products to serve this purpose have been available for years.  One of the most important questions to consider before using a graft is how will the body react to the graft– or in other words– will the graft be rejected by the body?

For instance, the Restore Patch  has been available since 1999 and is not recommended due to concerns about complications and rejection.  Because of these and other concerns, we avoided using patch grafts until we were comfortable that grafts that would be treated favorably by the patient’s body were available, and we had developed a reliable Arthroscopic Rotator Cuff Repair with Graft Reinforcement Technique. Among the grafts available today, Allopatch HD and GraftJacket appear to have the most favorable supporting science.

Numerous other options –including tendon transfers– may also be considered.

In summary, failed surgeries require careful analysis to prescribe the best possible technique for your individual circumstance. Click here to learn about superior capsular reconstruction

To schedule an appointment with a shoulder specialist contact us.

18 thoughts on “Failed Shoulder Surgery or Rotator Cuff Repair

  1. I had rotor cuff repair done last May 18th 2016, in mid August I was doing my physio at home and had a sharp pain in the arm. I immediately put my sling on and went to the Dr.’s office. Unable to see him I went to my physio and he had a look and said there was no discoloration. A week later I did see the Dr. and he felt that it was probably just a little set back. Through out the fall I continued to see the the Dr., things were not getting better. By December he said there was nothing else to do but go back in and have a look.
    I had my second surgery the end of January 2017. There had been a second tear.
    Having had a bad experience the first time I have been very cautious this time around, doing no work around the house. This past weekend (last weekend of April) I started having pain in the shoulder and the bicep. The only thing I can think I did and maybe should not have was I crawled under my back deck. The space underneath is a bout 2.5 feet. While under I favored my good arm and was only under for 2 minutes.
    I have seen my physio twice this week and she tends to think it’s nothing to be concerned with but has said to cut back on the exercises.

    In your opinion have I compromised my shoulder again?

    1. Dear GSS, Thanks for your inquiry. I would have to evaluate you personally to be able to provide information regarding your specific case. We have online scheduling available on our website, or if you wish you may call us at 317-802-9686 to schedule an appointment. Best regards, Dr. Agrawal

  2. Dr. I was in a motorcycle wreck may 30th 2014. Tore cuff and it was in a sling from may 30th 2014 till Oct 31 2014 due to brain injuries. They didn’t do my shoulder surgery cause it wasn’t life threatening. I had one surgery Oct 31 2014, May 8 2015, Feb 23 2016 and Dec 13 2016. Humerus repair cuff repair scar tissue removal and bicep tenodesis on my last surgery. It has been torn in different spots everytime. Now as of Dec 30 2016 I have a cuff tear and long head bicep tear. I’ve seen 3 different doctors and now trying to find someone to do a reverse replacement. I’ve looking at alot of reviews and seen that for a deficient rotator cuff the reverse replacement will help alot. Pain is a every day thing but it’s okay cause it’s been apart of me for so long. Do you have any idea what else may help besides the replacement and I’m having a hard time finding a doctor to do it cause of my age. I’ve seen 3 doctor’s and they won’t do the replacement cause I’m only 24 and they said it would last about 7 years. Please email me when you get a chance if you have anything that might help. It’s been an on going problem for 3 years now and I’m ready for it to get fixed. Thank you. Email.

    1. Dear Mark, You have had a very complex injury and I would have to evaluate you personally and obtain any additional necessary testing to be able to provide you with an assessment of the options available for you. Speaking only in general terms, many patients that previously would have only been candidates for a reverse total shoulder replacement are greatly benefitting from arthroscopic superior capsular reconstruction. Best regards,
      Dr. Agrawal

  3. Had orthsopic shoulder surgery in Newmarket Ont. Canada over 5 yrs ago
    The pain has gotten worse unbearable now.Even with fairly high doses of opiates
    Cannot use my left arm simple tasks like getting dressed even brushing hair slow very painfull.Sleep is rare almost impossible HELP!!??

    1. Thanks for your inquiry. It is not clear to me that you have a clearly establish diagnosis for your ongoing pain and debility. I recommend having an evaluation with a shoulder and neck/spine specialist. Best regards,
      Dr. Agrawal

  4. I have had a massive repair on left shoulder last August, seems very aggressive PT has undone surgery. MD only wants to either replace shoulder or leave alone and let me have Mild PT and cortizone injections for pain. I am not pleased with my options. What do you recommend since you can on l y speak with no MRrI or my presence for exam. I am vibrant,busy 77 yr old ex athelete female. Exercized,swam,horseback,etc… am turning into a vegetable like this…..

    1. Dear Lucinda, Thanks for your inquiry. As we have discussed previously, patients tend to focus on techniques, but ultimately, the surgeon is the method:
      By this, I mean that in my experience the best method in one surgeon’s hands is not the best option available out there. As you mentioned, without the opportunity to examine you personally I cannot determine if you would be a good candidate for some of the advanced arthroscopic options, reinforcement graft or superior capsule reconstruction, mentioned on our website. Best regards,Dr. Agrawal

  5. I just had an arhroscopy for rotator cuff Doctor told me that it can not be repaired as he is unable to stretch the tissues or muscles as they r torn badly. And he tried to clean as much as possible. I don’t know what he meant and what should I do now.

    1. Thanks for your inquiry. While many surgeons perform shoulder surgery, very few surgeons have the skill, experience and expertise needed to perform arthroscopic grafting for rotator cuff repair or superior capsular reconstruction. I would recommend you seek a second opinion with such a shoulder specialist to better determine the best options available to you personally.
      Best regards,
      Dr. Agrawal

  6. In 1994 I had a capsule surgery. I think it was called a putti-plat. After this many years i am starting to have the same symptoms of dislocation. Does this type of surgery fail or do the tissues just eventually stretch out and fail?

    1. Dear Jeff Thomas,
      Thanks for your inquiry. In general the putti-plat procedure was one of the common non-anatomic procedures designed to tackle anterior shoulder dislocations that had promising early results but very disappointing long term results. The procedure was designed to limit external rotation which aside from limiting some activities like overhead sports and throwing, etc. was also associated with the development of shoulder arthritis. This, of course, is a very general overview, and a detailed evaluation is necessary to provide more meaningful guidance for any individual case.
      Best regards,
      Dr. Agrawal

  7. 2 surgeries since April 2016. Recent one was October 2106. Things were going well till recent. Unable to effectively complete pt due to pain, loss of rom and weakness in are. What should I do?

    1. Dear Angie Wilson, Thanks for your inquiry. We don’t have a way to track the abilities and results of other surgeons. We suggest sharing the information on our website with your physician and asking the tough questions. Keep in mind that a second or third opinion may be an option to consider.
      Best regards,
      Dr. Agrawal

  8. Would like to know if a doctor diagnosis with failed rotary cuff also had 3rd shoulder replacement on that side should have advise treatment (shoulder) doctor

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