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. 2024 Dec 5:60:102852.
doi: 10.1016/j.jcot.2024.102852. eCollection 2025 Jan.

Strategies to mitigate complications in arthroscopic rotator cuff repair

Guido Fierro  1   2   3 , Gabriela Gómez Romero  1   2 , Jorge Rojas Lievano  1   2 , Juan David Lacouture  3 , Juan Carlos González  1   2
Affiliations

Strategies to mitigate complications in arthroscopic rotator cuff repair

Guido Fierro et al. J Clin Orthop Trauma. .

Abstract

The rotator cuff, a vital group of tendons and muscles in the shoulder, is essential for stabilizing the joint and enabling a wide range of arm movements. Rotator cuff tears, common across all age groups, often cause significant pain and functional limitations. Rotator cuff repair surgery aims to alleviate pain, restore function, and improve quality of life. Recent advances, particularly in arthroscopic techniques, have enhanced surgical outcomes and shortened recovery times. Nevertheless, risks remain, including surgical site infections, tendon retears, stiffness, severe postoperative pain, and nerve injuries. This article explores the complexities of rotator cuff repair, dividing complications into intraoperative and postoperative categories. Key challenges in arthroscopic techniques include ensuring optimal visualization, preventing anchor pullout, and managing chondral damage. Postoperative concerns such as infections, stiffness, and retears are also discussed, with an emphasis on preoperative skin preparation and emerging interventions like benzoyl peroxide application and platelet-rich plasma. By incorporating surgical innovations, evidence-based protocols, and comprehensive patient management, clinicians can enhance outcomes and recovery rates. The ongoing exploration of new treatments and collaborative research efforts are crucial for refining treatment protocols and advancing orthopedic patient care.

Keywords: Arthroscopy; Infection; Retears; Rotator cuff repair; Shoulder stiffness.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Arthroscopic image showing suboptimal visualization due to intraarticular bleeding in the subacromial space of left shoulder.
Fig. 2
Fig. 2
Elevated fluids during surgery to achieve the required pressure. Bags should be at the same level.
Fig. 3
Fig. 3
Arthroscopic image demonstrating intraoperative anchor pullout in a right shoulder.
Fig. 4
Fig. 4
Patient positioned in lateral decubitus.
Fig. 5
Fig. 5
Patient positioned in beach-chair position.
Fig. 6
Fig. 6
Arthroscopic image demonstrating fracture of the greater humerus tuberosity: an anchor was being inserted into the greater tuberosity through the anterior portal. The patient is a 72-year-old woman with a non-traumatic rotator cuff tear and a medical history significant only for hypertension.
Fig. 7
Fig. 7
Chlorhexidine-based sterilization preparation.
Fig. 8
Fig. 8
Postoperative MRI scan of patient with retear of the tendon of the supraspinatus.
See this image and copyright information in PMC

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