Revision repair for the failed rotator cuff

The surgical management of rotator cuff tears (RCT) has risen consistently with continuous evolvement of open and arthroscopic techniques. Over the past decade, the incidence of arthroscopic RCT repairs has increased by almost 600%, whereas the use of open techniques only increased by 34%. However, as the rate of primary RCR increases, the number of failures and subsequent revisions is likely to increase. Arthroscopic revision rotator cuff repair can be technically demanding, and the complication including failure rates are high. Compared to primary arthroscopic rotator cuff repair, outcomes following revision surgery are generally reported to be less satisfactory but remain high. Several patient-related risk factors are known to have a negative association with worse outcomes, however, prognostic and risk factors associated with unsuccessful results after reconstruction of the rotator cuff are poorly understood. The aim of shoulder surgeons should be to avoid unsatisfactory results and help in managing patients' expectations.