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.

12 thoughts on “Failed Shoulder Surgery or Rotator Cuff Repair

  1. 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…..now 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: https://www.theshouldercenter.com/pain/specialists-skill/
      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

  2. 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

  3. 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

  4. 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

  5. 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

Leave a Reply

Your email address will not be published. Required fields are marked *