Revision arthroscopic rotator cuff repair: systematic review and authors' preferred surgical technique.

PURPOSE

Recurrent tear after rotator cuff repair is not uncommon. Advances in arthroscopic shoulder surgery have created opportunities to better evaluate and treat these failures. The purposes of this systematic review were to evaluate the reported results of revision arthroscopic rotator cuff repair (ARCR) and to describe our technique of revision ARCR.

METHODS

A PubMed search from 1950 to 2011 was performed to identify articles describing revision rotator cuff repair. Studies were included in this systematic review if (1) they focused on revision ARCR, (2) they provided Levels I-IV evidence relevant to the search terms, (3) at least a partial repair was performed, and (4) they had a minimum of 12 months' follow-up.

RESULTS

We identified 4 articles that discussed the techniques and the results of revision ARCR. In all studies there were improvements in postoperative motion and functional outcome scores. Poorer results were associated with female patients, tear recurrence after revision repair, preoperative active forward flexion of less than 135°, and preoperative pain score greater than 5 on a visual analog scale.

CONCLUSIONS

This systematic review suggests that revision ARCR can frequently lead to improvement in functional outcome and reasonable patient satisfaction.

LEVEL OF EVIDENCE

Level IV, systematic review of Level IV studies.