King James IV Lecture 2011: Rotator Cuff Repair—Beyond Arthroscopic Repair

Abstract

60-year old patients really want a strong repair that works for sufficiently long time in a hostile environment to allow soft tissue matrix union (which remains structurally intact for a decade, relieves pain, allows accelerated rehabilitation and an early return to normal function at home and at work with minimal complications). Perhaps we have spent too much time thinking about the surgical approach to cuff repair, rather than about cuff repair, and it is time to redress the situation because re-tear rates (failure to heal) and postoperative down-time remain a challenge for the 21st Century.