Rotator Cuff Surgery Results: Only 1/2 of Athletes Return to Play!

by Chris Centeno, MD /

rotator cuff surgery results

Throwing and other athletes tear their rotator cuff all the time, and you would expect that modern orthopedic surgery would have a great answer for these highly active patients. However, a recent study shows rather poor rotator cuff surgery results with professional and competitive athletes. In fact, less than half returned to the same level of play after surgery. Yikes!

The Problems with Rotator Cuff Surgery

The rotator cuff supports the shoulder joint. It’s a compact series of muscles and tendons that keep the ball and socket of the joint nice and stable. Rotator cuffs can tear, both in athletes and even through normal wear and tear as we age. When it tears, surgeons love to look inside the shoulder and sew it up, but perhaps the biggest problem with this is the fact that just because a patient shows a rotator cuff tear on their MRI doesn’t mean this is the true source of the patient’s pain.

The truth is, after surgery. many patients never recover their full range of motion, and the pain continues. It would seem obvious that if you have shoulder pain in conjunction with a rotator cuff tear, the tear must be causing the pain, but it’s not that simple. Before we get into the recent study on athletes and rotator cuff tears, I’ve covered many studies on this blog over the years that show no connection between the rotator cuff tear or its severity and the patient’s shoulder pain. Click on the link in the prior paragraph to access these studies, but here is a brief overview:

  • The conclusions of one study force us to ask the question, If surgeons are stitching up rotator cuff tears to address pain, but the tear isn’t the true source of the pain, why surgery? The study’s conclusion: Pain and function in the shoulder isn’t “fixed” by a rotator cuff surgery!
  • A study out of Japan concluded that the shoulder pain was due to inflammation in the joint, not the tear. The study found that the more interleukin 8 (IL-8), an inflammatory marker, there was in the joint fluid, the more inflammation, and, hence, pain, was present. There was actually less pain in the larger rotator cuffs.
  • Another study stated that even in full-thickness rotator cuff tears, patients may show no symptoms. So pain shouldn’t automatically be associated with a rotator cuff tear. This study concluded that even if there is pain due to the rotator cuff tear, in most cases physical therapy should be able to address it.
  • Severity of the rotator cuff tear, according to another study, has nothing to do with pain level. In fact, in this study, it was comorbidities, and even education and race, that were associated with the level of pain.
  • Just this year, a study stated, “It is becoming clear that symptoms of rotator cuff tears do not correlate with disease severity.” The results showed that the patient’s mental health impacted pain level, and, additionally, it showed no association with full-thickness rotator cuff tears.

It’s clear to see now why rotator cuff tears and shoulder pain aren’t an obvious or given connection. Even in athletes whose pain may have begun in conjunction with the rotator cuff tear—it could be the inflammation, not the tear, for example, causing the pain. It’s also clear to see why for many types of rotator cuff tears (even the full-thickness ones) surgery may not be any better than no surgery, and who wants to undergo invasive surgery for no reason? Additionally, in 6 in 10 patients with large rotator cuff tears, retears occur following surgery and rotator cuff tears don’t heal following surgery in 1 in 3 patients over age 60.

Now let’s look at the new study.

The New Research Showing That Rotator Cuff Surgery Results Are Awful for Athletes

The new research looked at 25 studies that involved the surgical repair of a rotator cuff tear in athletes where the follow-up was at least two years. There were 286 competitive or professional athletes and 349 recreational athletes. While rotator cuff surgery results were manifested in a high level of return to play for recreational athletes, the ability of the professional athletes to return to play was very poor. Of the professional and competitive athletes, only 49.9% returned to the same level of play! Ouch!

The upshot? Why is this happening? As you can see above, while we’d all like to believe that shoulder rotator cuff surgery is effective, the research on rotator cuff surgery results is not great. Having less than half of the patients return to the same level of play they were at before their injury and surgery is awful, which makes me wonder why high-level athletes are still routinely getting this surgery.

Leave a Reply

Your email address will not be published. Required fields are marked *

6 thoughts on “Rotator Cuff Surgery Results: Only 1/2 of Athletes Return to Play!

  1. David Davenport

    “Having less than half of the patients return to the same level of play they were at before their injury and surgery is awful, which makes me wonder why high-level athletes are still routinely getting this surgery.”

    Why? Here’s the reason: If you go to an orthopedic surgeon
    with an acute shoulder or knee complaint, the doc will recommend surgery. That’s the way it is.

    Furthermore, insurance will cover the surgery, as will Medicare.

    High-level athletes? Operating on them is powerful advertising.

    1. Regenexx Team Post author

      David,

      All true. Thankfully, there are signs that the giant paradigm is beginning to shift, albeit an inch at a time…

  2. Douglas Kennedy

    I had a full-thickness supraspinatus tear, large labrum tear, and biceps LH partial tear after 27 years of being a chiropractor. Rotator cuff surgery has been very good as far as regular day-to-day activities go…BUT not so good when it comes to the high speed explosive movements required of my profession. I am looking forward to my Regenexx procedure later this month!! My surgeon also did acromioplasty which now shows signs of instability on real-time ultrasound (another innovative procedure done at Regenexx). Would it be beneficial to try stem cells or start with PLP ?

    1. Regenexx Team Post author

      Douglas,

      That would be up determined by the exam, as fitting the right procedure to the right issue is crucial. In complex cases, both may be used.

    2. Joey

      Hello, I also have a full thickness tear in my rotator cuff and the majority of my labrum is torn, both in the same shoulder. I am a high school swimmer looking to continue swimming after my surgery in college. Do you have any advice? I have one surgeon saying that we should not fix the rotator cuff and deal with the labrum as the main source of pain, while a different surgeon wants to operate on my rotator cuff as well because he believes that’s the source of pain. I am having a hard time deciding between the two and just wondering which one would likely have the best results in my future swimming. Do you think the rotator cuff was the main source of your pain?

      1. Regenexx Team Post author

        Joey,
        If the goal is to continue competitive swimming, the best advice would likely be to avoid the surgery altogether, if possible. We’d need to examine you to determine what the source of your pain is. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/shoulder-labrum-surgery-side-effects/ and https://regenexx.com/blog/rotator-cuff-surgery-results/ and https://regenexx.com/blog/avoid-rotator-cuff-surgery-2/ and https://regenexx.com/blog/patient-rotator-cuff-stem-cell-injection-rct/ and https://regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ If you’d like to see if you would be a Candidate, please submit the Candidate form.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.