title: Critical period and risk factors for retear following arthroscopic repair of the rotator cuff.
abstract: OBJECTIVE
  The incidence of retear following rotator cuff repair remains a major concern, and the cause and timing of retear remain unclear. The aim of this study was to prospectively investigate the timing of retears following rotator cuff repair at multiple time intervals. The hypothesis was that the 'critical period' for retears extends beyond the first three post-operative months.
  
  
  METHODS
  The authors prospectively studied 206 shoulders that underwent arthroscopic double-row (without suture bridge) suture anchor repair for rotator cuff tears. Patients were recalled to three follow-up visits at the following post-operative time intervals: 3, 6, and 12 months or longer. Ultrasonography was performed at each visit, and Constant score was collected during the last visit.
  
  
  RESULTS
  A total of 176 shoulders attended all required follow-up visits with mean age 56.0 years. Ultrasonography revealed retears in 16 shoulders (9.1 %) at 3 months, in 6 shoulders (3.4 %) at 6 months, and in 5 others (2.8 %) at the last follow-up, while it confirmed intact rotator cuffs in 149 shoulders (84.7 %) at the last follow-up (median 35.5; range 12-61). The incidence of retears was significantly associated with tear size (p = 0.001) and tendon degeneration (p = 0.003).
  
  
  CONCLUSIONS
  The 'critical period' for healing following rotator cuff repair, during which risks of retears are high, extends to the first 6 months. The risk of retear is greatest for massive 3-tendon tears, which may require longer periods of protection. The clinical relevance of this study is the identification of patients at risk of retear and the adjustment of their rehabilitation strategy and time for return to work.
  
  
  METHODS
  III.
authors: Department of Orthopaedic Surgery, Clinique des Cèdres, Grenoble, France.
authors: Johannes
authors: J
authors: Barth
authors: Department of Orthopaedic Surgery, Clinique des Cèdres, Grenoble, France.
authors: Kevin
authors: K
authors: Andrieu
authors: Department of Orthopaedic Surgery, Clinique des Cèdres, Grenoble, France.
authors: Elias
authors: E
authors: Fotiadis
authors: Orthopaedic Research Laboratory, Radboud University Medical Center, 6525, Nijmegen, The Netherlands.
authors: Gerjon
authors: G
authors: Hannink
authors: Department of Radiology, Clinique du Mail, Grenoble, France.
authors: Renaud
authors: R
authors: Barthelemy
authors: Department of Medical Research, Alliance Scientifique SAS, Lyon, France. saffarini@mac.com.|Department of Medical Technology, Accelerate Innovation Management SA, Geneva, Switzerland. saffarini@mac.com.
authors: Mo
authors: M
authors: Saffarini
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D011184:Postoperative Period; D012307:Risk Factors; D017006:Rotator Cuff / Q000601:surgery*; D012421:Rupture / Q000601:surgery*; D012782:Shoulder / Q000503:physiopathology / Q000601:surgery*; D053441:Suture Anchors; D013537:Sutures; D014463:Ultrasonography
keywords: Arthroscopic rotator cuff repair; Double-row repair; Retear; Rotator cuff tear; Shoulder