Treatment Options: Nonoperative and Operative
Surgical Technique Setup
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The Failed Rotator Cuff Repair: Evaluation and Surgical Management
Failed rotator cuff repair includes patients with recurrent tears; however, it also includes those patients who have not achieved adequate pain control or improved functional outcomes following the index procedure. There are intrinsic and extrinsic factors that contribute to persistent symptoms. The intrinsic factors are specific to the rotator cuff itself and a recurrent tear. The extrinsic factors include persistent biceps symptoms, symptomatic acromioclavicular (AC) joint arthritis, glenohumeral arthritis, unrecognized instability, and persistent subcoracoid impingement.
Arthroscopic or open rotator cuff repair involves the reattachment of the tendinous rotator cuff complex to the appropriate tuberosity insertion. However, it also includes managing any other additional pathology (i.e., AC joint arthritis, any causes of impingement, biceps pathology, adhesive capsulitis, glenohumeral arthritis, implant complications, poor bone quality, and so forth) not addressed at the index procedure.
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