Arthroscopic Rotator Cuff Repair Failure Resulting From Decortication of the Rotator Cuff Footprint: A Case Report

Abstract not available. Introduction provided instead.

During the past decade, arthroscopic rotator cuff repair has become increasingly popular among sports medicine arthroscopists. At the same time, advances in arthroscopic technology have led to the development of innovative anchoring devices for the repair of rotator cuff tears. Device failure is probably a less common cause of either rotator cuff re-tears or initial failure to heal. However, arthroscopic rotator cuff repair failure involving the fixation device may occur at the level of the suture, at the suture–anchor junction, or at the anchor itself. Preclinical data suggest that normal rotator cuff healing occurs at the bone–tendon interface and that simple superficial decortication is probably all that is required to promote this healing.¹ Historically, however, several authors have popularized using bone troughs or aggressive decortication to ensure adequate blood supply for tendon-to-bone healing. Although this technique may not compromise outcomes after the traditional placement of trans-osseous sutures during open rotator repair,
it may have far different consequences for suture anchor fixation, which depends on an intact cortical shelf for optimizing the biomechanical environment.

In this case report, we describe an arthroscopic rotator cuff repair failure most likely resulting from decortication of the rotator cuff footprint and subsequent biomechanical failure of the anchor.