CORR Insights^®: Muscle Fibers are Injured at the Time of Acute and Chronic Rotator Cuff Repair

Excerpt

While rotator cuff repair has an excellent track record in terms of pain relief, recovery of strength after surgery is not as consistent [7]. Some patients have persistent symptoms [4]. With time, torn rotator cuff muscles atrophy and undergo fatty infiltration [5]. This process worsens with time and as the tendon retracts medially. Even a successful repair defined as successful tendon healing at best stabilizes these muscle changes and does not reverse them [2]. Despite our technological and recent biologic advances, overall the rate of tendon retear is still high, and repairs of chronic tears are more likely to fail [9]. There is some evidence that lengthening of the tendon for repair could cause traction related muscle injury leading to muscle cell plasma membrane disruption and permanent injury [1]. Some surgeons prefer to perform a medialized repair when significant tension is noted while reducing a chronically retracted tendon with the goal of decreasing tension on the repaired tendon [3]. This may be a reason to consider intercalary grafting of tears that cannot be sufficiently lateralized without undue tension. …