2011 Volume 35 Issue 3 Pages 857-859
We examined patients with re-tear of the rotator cuff after arthroscopic repair performed at our hospital by MRI and evaluated its causes.The subjects were 105 shoulders. The size of the complete tears was small in 27 cases, medium in 59 cases, and large in 19 cases. The repair methods were the dual row technique (DR), suture bridge (SB), and DAFF. The supraspinatus and infraspinatus were evaluated by MRI taken more than 6 months after surgery. Type 4 or 5, according Sugaya's classification, were defined as re-tear, and re-tear rate, the age at the surgery, its relationships with re-tear site, preoperative tear size, and suture method were evaluated. Re-tear was observed in 12 shoulders and was type 4 in 11 and type 5 in 1. The mean age at surgery was 74.6 years old in those who suffered re-tear and 67.8 years old in those showing complete repair, with a significant difference. The site of re-tear was the medial suture site in 6 cases, lead-in area from the stump in 5 cases, and side-to-side suture site in 1 case. Re-tear was observed in 5 cases with medium tears, and 7 cases with large tears. Re-tear was observed in 4 cases treated with DR, 8 cases treated using SB. No re-tear was noted in the shoulders after DAFF. The concentration of medial stress is considered to be the main factor in re-tear on the medial side. To prevent re-tear, it is considered important to select a repair technique that does not allow the concentration of stress at the medial suture site for small and medium tears, and to select methods such as the patch method for large tears.
