title: Complications after arthroscopic revision rotator cuff repair.
abstract: OBJECTIVE
  The purpose of this study was to determine the complication rate of arthroscopic revision rotator cuff repair (ARRCR).
  
  
  METHODS
  The retrospective review included 94 patients who underwent ARRCR performed by the 2 senior authors between January 2000 and June 2009 (mean age, 52 years; age range, 44 to 72 years). Sixty-four patients underwent 1 revision rotator cuff repair, 23 patients underwent 2 revisions, and 7 patients underwent 3 or more revisions. The rotator cuff tear at the time of the revision was characterized as massive (>5 cm) in 51 patients (54%), large (>3 to 5 cm) in 14 patients (15%), medium (1 to 3 cm) in 17 patients (18%), and small (<1 cm) in 12 patients (13%). There was a single-tendon tear in 12 patients (13%), 2 tears in 31 patients (33%), and 3 or 4 tears in 51 patients (54%). Additional procedures included revision acromioplasty (n = 66), distal clavicular excision (n = 19), biceps tenodesis (n = 52), suprascapular nerve release (n = 14), and loose anchor removal (n = 6).
  
  
  RESULTS
  Complications developed in 19 patients (20.2%) within 1 year of undergoing ARRCR. The complications included failure to heal (10.6%, n = 10), stiffness (7.4%, n = 7), infection (2.1%, n = 2), and nerve injury (1.1%, n = 1). A direct correlation was found between the complication rate and the number of revision surgeries: 14% after 1 revision, 17.4% after 2 revisions, 33% after 3 revisions, and 50% after 4 or more revisions. The minimum follow-up of all the patients in this study was 1 year. We continued to follow up every patient who was diagnosed with complications during this year until resolution of the complication, or we are still continuing to perform follow-up of these patients.
  
  
  CONCLUSIONS
  The complication rate after ARRCR is about twice the published rate for primary rotator cuff repair. There is a direct correlation between the complication rate and the number of revision surgeries. The most common complication recognized was failure to heal because of poor tissue quality.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Harvard Shoulder Service, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Nata
authors.initials: N
authors.lastname: Parnes
authors.forename: Michael
authors.initials: M
authors.lastname: DeFranco
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Wells
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Higgins
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D017211:Treatment Failure; D014945:Wound Healing