SPECIAL FOCUS: Upper ExtremityFailed rotator cuff surgery: what can we do?Bicknell, Ryan T.Author Information Division of Orthopaedic Surgery, Department of Surgery, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada Correspondence to Ryan T. Bicknell, MD, MSc, FRCSC, Division of Orthopaedic Surgery, Department of Surgery, Kingston General Hospital, Nickle 3, 76 Stuart Street, Queen's University, Kingston, Ontario, Canada K7L 2V7 Tel: +613 549 6666 x6333; fax: +613 548 1336; e-mail: firstname.lastname@example.org Current Orthopaedic Practice: September 2010 - Volume 21 - Issue 5 - p 448-452 doi: 10.1097/BCO.0b013e3181e69f6a Buy Metrics Abstract Failure after rotator cuff surgery represents a difficult and challenging problem. Patients may complain of persistent pain, stiffness, weakness or loss of function, usually loss of active anterior elevation, but often loss of active external rotation, with impairment in activities of daily living. Patients with pain and preserved function often are adequately treated with physiotherapy, steroid injection, or procedures such as repair for a reparable tear, debridement, biceps tenotomy or tenodesis, partial repair or tendon transfers for irreparable tears, or hemiarthroplasty in the presence of glenohumeral arthritis. However, patients with loss of function often are not adequately treated by any of these methods and often require a reverse shoulder arthroplasty, which can improve function in selected patients. However, results are lower than primary surgery, with a higher complication rate. As experience and technology continue to advance, newer treatment options may offer further promise for this challenging patient population. © 2010 Lippincott Williams & Wilkins, Inc.