I am planning to have rotator cuff surgery and am worried about potential for a retear. I am a pretty active person and want to be sure that I can play softball again next summer. What are the chances that I will retear my rotator cuff?

Utilizing a traditional rehabilitation protocol involving immediate physical therapy for passive range of motion, reports vary between 20 per cent and 40 per cent of rotator cuff repairs resulting in a retear. There have been many improvements made in suture techniques to decrease this rate but little change in the rehabilitation protocol. Animal studies have shown that a period of immobilization following rotator cuff repair decreases the retear rate.

A recent study published in The Journal of Bone and Joint Surgery investigated the effectiveness of immobilization after surgery in human subjects. The goal was to determine if longer periods of immobilization resulted in any clinical differences in outcomes, including shoulder range of motion, retear rates and clinical outcome scores. One hundred participants who met specific criteria and underwent arthroscopic repair of the rotator cuff were randomly sorted into two groups. One group was immobilized after surgery for four weeks, the other was immobilized for eight weeks. After the allotted time of immobilization each participant underwent rehabilitation with a physical therapist that included passive range of motion then progressed to active range of motion and strengthening.

At follow up conducted at six months and 24 months after surgery, there were no statistical differences between the groups with retear rates, but the overall retear rate for both groups was 10 per cent. This much lower than retear rate reported (20-40 per cent) with other studies that involved immediate passive range of motion after surgery. If you want to diminish your chances of retear consult with your surgeon to determine if a period of immobilization after surgery would be advised.