From the Research
The retear rate after rotator cuff repair can range from 10% to 94%, with the most recent and highest quality study suggesting a retear rate of 19.3% with the use of platelet-rich plasma (PRP) compared to 25.4% without PRP 1.
Factors Influencing Retear Rate
The retear rate after rotator cuff repair is influenced by multiple factors, including:
- Patient-related factors such as advanced age, smoking, diabetes, osteoporosis, and poor tissue quality
- Tear characteristics such as larger tear size, chronic tears, fatty infiltration of muscles, and tendon retraction
- Surgical technique, with double-row repairs generally showing lower retear rates than single-row repairs
- Rehabilitation protocol adherence, which significantly impacts healing success
Importance of PRP in Reducing Retear Rate
The use of PRP in arthroscopic rotator cuff repair has been shown to reduce the retear rate and improve clinical outcomes, including pain levels and functional outcome scores 1, 2.
Key Considerations for Minimizing Retear Risk
To minimize retear risk, it is essential to:
- Regularly follow up with physical therapy
- Avoid overhead activities during early healing
- Maintain proper nutrition
- Quit smoking
- Consider the use of PRP in arthroscopic rotator cuff repair, especially in single-row fixation 3
Clinical Implications
Despite retears, many patients still experience significant pain relief and functional improvement compared to their pre-operative state. Therefore, it is crucial to prioritize morbidity, mortality, and quality of life when making treatment decisions, and to consider the use of PRP in arthroscopic rotator cuff repair to reduce the retear rate and improve clinical outcomes.