This narrative review surveys the complications that follow arthroscopic rotator cuff repair. It covers technical, medical, and miscellaneous complications with their reported incidence ranges. The goal is to help surgeons recognize, prevent, and treat these problems.
The single most actionable pearl here is to avoid intra-articular pain pumps with local anesthetic after shoulder arthroscopy. Local anesthetics trigger chondrocyte apoptosis, and the literature supports a causal link to postarthroscopic glenohumeral chondrolysis. Bupivacaine is the worst offender. This is a rare complication, but it can destroy a joint in a young patient within months.
For retear, understand that the 4.5% to 94% range reflects definitional chaos, not biology. Full-thickness retears genuinely lower functional scores, so tear size >3 cm, smoking, and fatty infiltration are the risk factors to counsel and optimize.
On rehab, the old dogma that immobilization causes long-term stiffness is not supported. Delayed protocols do not increase permanent stiffness, giving you room to protect the repair. Finally, P. Acnes drives most deep infections and grows slowly, so hold cultures and keep suspicion high when a repair sours.
This narrative review surveys the complications that follow arthroscopic rotator cuff repair. It covers technical, medical, and miscellaneous complications with their reported incidence ranges. The goal is to help surgeons recognize, prevent, and treat these problems.
The single most actionable pearl here is to avoid intra-articular pain pumps with local anesthetic after shoulder arthroscopy. Local anesthetics trigger chondrocyte apoptosis, and the literature supports a causal link to postarthroscopic glenohumeral chondrolysis. Bupivacaine is the worst offender. This is a rare complication, but it can destroy a joint in a young patient within months.
For retear, understand that the 4.5% to 94% range reflects definitional chaos, not biology. Full-thickness retears genuinely lower functional scores, so tear size >3 cm, smoking, and fatty infiltration are the risk factors to counsel and optimize.
On rehab, the old dogma that immobilization causes long-term stiffness is not supported. Delayed protocols do not increase permanent stiffness, giving you room to protect the repair. Finally, P. Acnes drives most deep infections and grows slowly, so hold cultures and keep suspicion high when a repair sours.