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Healing of Rotator Cuff Reruptures is Possible

Rotator cuff tears of the shoulder can be repaired surgically. Some patients rerupture the repair. This report offers a long-term look at 20 patients with rerupture of the rotator cuff repaired the first time with an open incision. Short-term results for this same group were reported after 3.2 years. The results reported here were measured after 7.6 years.

Clinical exam, X-rays, and MRI were used throughout follow-up with these patients. X-rays were used to show arthritic changes in the shoulder joint. MRIs showed the condition of the torn tendon(s). Motion, strength, and function were also measured.

After the first three years, the patients with a rerupture still had better results than before surgery. After seven and a half years no one was any worse. Some patients were better than at the three-year check-up. Eight of the 20 showed healing had occurred. For those who still had a rupture, there was no change in the size of the tear.

There were some changes seen between three and seven years. For example there were more arthritic changes in the shoulder joint. Some of the rotator cuff tendons had developed a lot of fatty streaks called fatty infiltration. The authors suspect further deterioration will occur with age.

Results of this study show that small rotator cuff reruptures can heal over time. Changes can be seen in the tissue as much as three years later. Most of the time this new tissue had reduced strength.

The authors say it's better to have surgery to repair a rotator cuff even if it tears again compared to leaving a tear untreated. Patients seem to have better overall function despite the rerupture compared with an unrepaired rotator cuff tear.

References: Bernhard Jost, MD, et al. Long-Term Outcome After Structural Failure of Rotator Cuff Repairs. In The Journal of Bone and Joint Surgery. March 2006. Vol. 88-A. No. 3. Pp. 472-479.

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