Evidence brief
Rotator Cuff Repair: Outcomes and Failure Rates
High retear rates (20-70%) depending on tear size
Clinical improvement occurs even with retear
Massive tears have highest failure rates
Fatty infiltration affects healing potential
Repair technique and biology both matter
Rotator cuff repair retear rates are significant, particularly for large and massive tears. However, clinical outcomes often improve despite structural failure. Patient factors (age, tear chronicity, fatty infiltration) affect outcomes.
Discuss the 'retear paradox' - patients improve clinically despite MRI showing retear. Know prognostic factors: tear size, fatty infiltration (Goutallier), muscle atrophy, patient age. Discuss repair augmentation strategies (patches, PRP).
Galatz LM et al. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219-224.
Level III
Retrospective comparative study or case-control study