Screw Removal After Rotator Cuff Repair
Direct Answer
There is no evidence-based guideline or research addressing the timing or indications for screw removal after rotator cuff repair, as this procedure does not routinely involve screw fixation.
Clinical Context and Clarification
The available evidence does not address screw removal because rotator cuff repair typically uses suture anchors, not screws that require removal 1. The surgical technique involves:
- Suture anchors placed in the greater tuberosity to reattach the torn tendon to bone, which are designed to remain permanently in place 2
- Bone-to-tendon healing that occurs through biological integration over 12 weeks, not through hardware that needs removal 2, 3
When Hardware Removal Might Be Relevant
If your question pertains to a different surgical scenario where metallic hardware was used (such as fracture fixation near the rotator cuff), consider:
Timing Based on Healing Principles
- Tendon-to-bone healing requires at least 12 weeks before the repair site achieves sufficient strength 2
- Active overhead use and strengthening should be delayed until 12 weeks postoperatively to minimize retear risk 2
- Any hardware removal should not occur before complete biological healing is achieved, which typically requires a minimum of 3-6 months 2, 3
Clinical Decision Points
- Symptomatic hardware (pain, irritation, impingement) is the primary indication for removal in any orthopedic procedure
- Removal should only be considered after confirming intact tendon healing on MRI or ultrasound imaging 4
- Age and healing capacity matter: patients over 65 years have poorer healing rates and may require longer protection periods before any secondary procedures 3
Common Pitfall
Do not confuse rotator cuff repair with other shoulder procedures that use plates or screws (such as proximal humerus fracture fixation or acromioclavicular joint reconstruction), as these have entirely different hardware considerations 1.