title: When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears.
abstract: BACKGROUND
  Despite advances in arthroscopic repair of rotator cuff tears, recurrent tears after repair of large and massive tears remain a significant clinical problem. The primary objective of this study was to define the timing of structural failure of surgically repaired large and massive rotator cuff tears by serial imaging with ultrasound. The secondary objective of this study was to investigate the association between recurrent tears and clinical outcome after rotator cuff repair.
  
  
  OBJECTIVE
  Recurrent tear after arthroscopic repair of large rotator cuff tears is more likely to occur late (>3 months) in the postoperative period and will be associated with inferior clinical outcome scores.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Twenty-two consecutive patients with large (>3 cm) rotator cuff tears underwent arthroscopic repair with a standardized technique. Serial ultrasound examinations were performed at 2 days, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. Western Ontario Rotator Cuff (WORC) Index scores were also collected at these time points.
  
  
  RESULTS
  Nine (41%) of the 22 arthroscopically repaired rotator cuff tears demonstrated recurrent tears. Seven of the 9 retears occurred within 3 months of surgery, and the other 2 occurred between 3 and 6 months. No retears occurred after 6 months. At 24-month follow-up, WORC scores favoring intact rotator cuffs over retears approached statistical significance (mean WORC intact 123.9 vs retear 659.8; P = .07).
  
  
  CONCLUSIONS
  Recurrent rotator cuff tears are not uncommon after arthroscopic repair of large and massive tears. These recurrent tears appear to occur more frequently in the early postoperative period (within the first 3 months) and are associated with inferior clinical outcomes.
authors: Division of Sports Medicine, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48105, USA. bsmiller@umich.edu
authors: Bruce S
authors: BS
authors: Miller
authors: Brian K
authors: BK
authors: Downie
authors: Robert B
authors: RB
authors: Kohen
authors: Theresa
authors: T
authors: Kijek
authors: Bryson
authors: B
authors: Lesniak
authors: Jon A
authors: JA
authors: Jacobson
authors: Richard E
authors: RE
authors: Hughes
authors: James E
authors: JE
authors: Carpenter
mesh_terms: D000368:Aged; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012008:Recurrence; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D017211:Treatment Failure; D014463:Ultrasonography