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Updated: Aug 5, 2026
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Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Preoperative Scaption and External Rotation Strength Deficits Are Predictive of Retear After Rotator Cuff Repair
Sang Min Lee1, Su Cheol Kim2, Jong Hun Park3
1Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Summary
Preoperative shoulder muscle strength, particularly in scaption and external rotation, predicts rotator cuff retears after repair. Muscle strength testing offers a practical alternative to MRI for assessing retear risk.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Imaging
Background:
- Rotator cuff repair aims to restore function but retears remain a concern.
- Predictive factors for retear are crucial for patient selection and postoperative management.
- Preoperative shoulder muscle strength has not been extensively studied as a predictor of retear.
Purpose of the Study:
- To evaluate the role of preoperative shoulder muscle strength in predicting rotator cuff retears following arthroscopic repair.
- To identify specific muscle strength deficits associated with increased retear risk.
Main Methods:
- Retrospective cohort study of 699 patients undergoing arthroscopic rotator cuff repair.
- Preoperative assessment included American Shoulder and Elbow Surgeons and Constant scores.
- Isometric handheld dynamometry measured strength in six shoulder positions.
- Rotator cuff retears were assessed via postoperative MRI.
Main Results:
- The retear rate was 11.87% (83 out of 699 patients).
- Significant predictors of retear included age, lower Constant scores, and deficits in scaption and external rotation strength.
- Strength deficits were compared between the injured and uninjured shoulders.
Conclusions:
- Preoperative scaption and external rotation strength deficits are independent predictors of rotator cuff retear.
- Muscle strength testing provides a practical, accessible method for assessing retear risk, especially when MRI is unavailable.
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