Twenty-seven patients with twenty-seven involved shoulders underwent a
second attempt at repair of an initial rotator-cuff repair that had failed.
Factors associated with the failure of the initial repair included a
massive or large tendon tear, damage to the deltoid origin at the original
surgery, and possibly inadequate postoperative external support. Seven
patients required a third operation because of continuing pain or weakness.
The remaining twenty patients were followed for a minimum of two years
(average, forty-eight months) and seventeen of them were examined at an
average of forty-six months (range, twenty-six to 118 months) after
surgery. Postoperatively, although seventeen patients (63 per cent) still
had moderate or severe pain, sixteen (76 per cent) of the twenty-one
patients who were operated on to relieve pain reported that the pain was
substantially diminished. Active abduction increased an average of 8
degrees, but only seven shoulders gained more than 30 degrees of active
abduction. Nineteen shoulders remained moderately or markedly weak in
abduction. Over-all, four patients (17 per cent) had a good result; six (25
per cent), a fair result; and fourteen (58 per cent), a poor result. These
results suggest that the surgeon should be quite hesitant to propose a
second attempt at rotator cuff repair to a patient, as although pain may be
diminished, active movement is unlikely to improve.