title: Factors affecting outcome after structural failure of repaired rotator cuff tears.
abstract: BACKGROUND
  Failure of structural healing is not infrequent after rotator cuff repair and often is not associated with clinical outcome. The goals of this study are to describe outcomes in a cohort of patients with a failed rotator cuff repair and to evaluate factors associated with clinical outcome.
  
  
  METHODS
  This was a retrospective study of all patients with failure of structural integrity after rotator cuff surgical repair. A threshold American Shoulder and Elbow Surgeons (ASES) score of 80 points was used to allocate patients into either the successful (≥80 points; Group 1) or unsuccessful (<80 points; Group 2) cohorts. Demographics, patient-centered instruments for shoulder function, radiographic parameters, and shoulder motion were compared between groups.
  
  
  RESULTS
  On the basis of the postoperative ASES score, thirty-three patients (54.1%) were included in Group 1 and twenty-eight patients (45.9%) were included in Group 2. Fifteen patients (53.6%) in Group 2 reported a labor-intensive occupation compared with two patients (6.1%) in Group 1 (p < 0.001). Multiple regression analysis demonstrated that labor-intensive occupation (odds ratio [OR], 202.3; p = 0.026), preoperative Simple Shoulder Test (SST) score (OR, 0.50; p = 0.028), and preoperative external rotation (OR, 0.91; p = 0.027) were associated with inclusion in Group 2. Age and other demographic variables, including sex, dominant-sided surgery, and medical comorbidities, were similar for the groups.
  
  
  CONCLUSIONS
  Successful outcomes were achieved in 54% of patients with failed rotator cuff repair. Those who self-identified their occupation as being labor-intensive represented a special group of patients who are at high risk for a poor outcome after a failed rotator cuff repair.
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107.
authors.forename: Surena
authors.initials: S
authors.lastname: Namdari
authors.affiliation: Bluegrass Orthopaedics & Hand Care, 3480 Yorkshire Medical Park, Lexington, KY 40509.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Donegan
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St. Louis, MO 63110. E-mail address for J.D. Keener: keenerj@wudosis.wustl.edu.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Chamberlain
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St. Louis, MO 63110. E-mail address for J.D. Keener: keenerj@wudosis.wustl.edu.
authors.forename: Leesa M
authors.initials: LM
authors.lastname: Galatz
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St. Louis, MO 63110. E-mail address for J.D. Keener: keenerj@wudosis.wustl.edu.
authors.forename: Ken
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St. Louis, MO 63110. E-mail address for J.D. Keener: keenerj@wudosis.wustl.edu.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Keener
mesh_terms: D000367:Age Factors; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009790:Occupations; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012737:Sex Factors; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D017211:Treatment Failure