My sister says I’m torturing myself over nothing. So I need to get another opinion besides my own (and hers, of course). I have a torn rotator cuff that was repaired and now it’s torn again — exact same muscle and exact same spot as the first tear. Should I have surgery to fix it a second time? Could it possibly heal on its own?

There isn’t a lot of data about recovery from retears of previously repaired rotator cuff tears. The studies that have been done report conflicting results. Some showed that spontaneous healing is possible. Others showed not one patient had any signs of recovery.

The question has been raised whether revision (second) surgery is even needed when a repaired cuff tear retears. Many patients are perfectly happy with the results even with a retear. They don’t have pain and they don’t notice much difference in how the arm works. Of course, the average age of patients in these studies was 62, so we’re talking about an older group. The same may not be true for younger, more active adults.

Surgeons have also started taking a look to see if by not repairing a second tear, patients are left at a disadvantage much later. It’s possible the tendon might deteriorate over time to the point that surgery would no longer even be possible. Then it’s too late and the damage is done.

The questions you ask are very valid and deserve a complete answer. Unfortunately, there isn’t enough information from studies to supply you with a definite answer one way or another. It might be helpful to ask your surgeon for his or her opinion. With imaging studies like MRIs and ultrasound and possibly arthroscopic examination, the size, location, and extent of the tear can be evaluated. Any change in your condition might warrant surgical repair but this is decided on a case-by-case basis.