Case example 1: Failure of rotator cuff repair

Abstract

Rotator cuff repair is a commonly performed procedure, with a recognised rate of failure. Even moderate-sized tears have a 40% recurrence rate, whilst large or massive tears have a reported rate of failure as high as 94%. Factors contributing to failure include size of tear, age of patient, quality of tendon, muscle atrophy and fatty degeneration plus the tension on the original repair. Despite advances in surgical techniques, better anchors, and better sutures the failure rate remains fairly constant. What needs to be altered is the biology of the situation. The use of patches allows repairs to be strengthened and supported. The use of the Leeds-Kuff Patch allows defects in the repair of a large to massive tear to be bridged and hence the tension on the repair can be reduced. Rapid tissue ingrowth dramatically reduces the risk of recurrence of tear and allows restoration of function.