Failed shoulder surgery happens when the procedure doesn’t meet the patient’s or doctor’s expectations. The failure rate for primary open or arthroscopic shoulder surgeries ranges from 5% to 30%. Therefore, it’s important to know about the symptoms of failed shoulder surgery. This can help you return to your healthcare provider on time.
What Is a Failed Shoulder Surgery?
Failed shoulder surgery is when the surgery causes ongoing pain or other unwanted symptoms. All surgeries come with risks, and some have higher risks than others. The most commonly reported failed shoulder surgeries are rotator cuff repairs and shoulder stabilization for instability.
Causes of a Failed Shoulder Surgery
According to Dr. Cusick. “A surgeon has a proper pre-surgery discussion with the patient. They set goals like reduced pain, improved functionality, increased strength, etc., that they wish to achieve from the procedure. Unfortunately, sometimes, they fail to meet the decided goals. Healthcare professionals regard these procedures as failed surgeries.” This failure can happen due to:
• Using implants that are too large for joint replacement
• Bone growth that limits movement
• Scar tissue forming and causing problems
• Infection
• Nerve damage leading to weakness
• Failure to heal a fracture
• Problems with rotator cuff repair
• Reactions to materials used in implants
• Inadequate rehabilitation after surgery
Common Symptoms of Failed Shoulder Surgery
Symptoms of failed shoulder surgery can vary based on the type of procedure and the person. Common surgeries involve the rotator cuff, labrum, or biceps tendon. While some discomfort and swelling are normal during recovery. However, ongoing issues or symptoms that return after recovery might suggest the surgery failure. These symptoms can include:
• Persistent pain that doesn’t get better with rest or medication
• Reduced joint movement
• Popping, clicking, or grinding noises when moving the joint
• Muscle weakness or shrinkage
• Swelling in the joint
Diagnosis of a Failed Shoulder Surgery
“A failed shoulder surgery can be hard to diagnose. However, a surgeon can help. First, your doctor will review your shoulder problem history. They can also ask for your previous surgery reports if you have any.” Says Dr. Michael C Cusick. You might need to provide:
• When your symptoms started
• Details of any shoulder injuries
• Information on any physical therapy or rehab after the surgery
Then, your doctor will:
• Examine your shoulder physically
• Order imaging tests to look at the joint and surgery site to find out what went wrong
How Long Should You Wait Before Returning to Your Surgeon?
The time it takes for symptoms to appear after shoulder surgery can vary a lot. Older data shows that about 3 out of 10 cases show symptoms within the first year, with the average being 48.7 months. However, it can take time to know if the surgery was successful, as some problems can appear years later.
Treatment Options for Failed Shoulder Surgery
When a patient experiences the symptoms of failed shoulder surgery, the first thing that comes to mind is the treatment options. The re-treatment is based on the severity of the problem. Your options include:
• Nonsurgical treatments, like physical therapy or medications
• Revision surgery to fix any further tissue damage or replace parts
• Joint replacement (arthroplasty) if no other options work
• Revision surgery can be complicated and is usually only considered if symptoms don’t improve or get worse after nonsurgical treatments.
Eligibility for revision surgery depends on the type of procedure. For failed rotator cuff repairs, usually the best candidates are:
• Under 70 years old
• Able to lift their arm more than 90 degrees
• Had tendon suturing or reattachment in the first surgery
The revision surgery will vary depending on the symptoms and the techniques used in the original procedure. The surgeon might need to remove scar tissue, repair new damage, or replace a part of the shoulder joint. Some other procedures include:
• Shoulder Resurfacing
• Acromioclavicular Joint (AC) Joint Reconstruction
• Subacromial Decompression
• Complex Shoulder Reconstruction
• Revision Shoulder Replacement
• Shoulder Joint Replacement
• Reverse Shoulder Replacement
• Minimally Invasive Shoulder Joint Replacement
• Sternoclavicular Joint (SC joint) Disorders
• SC Joint Injury Reconstruction
• SLAP Repair
• Arthroscopic Bankart Repair
• Shoulder Labrum Reconstruction
• Latarjet Procedure
• Shoulder Stabilization
• Shoulder Arthroscopy
• Distal Clavicle Excision
• Capsular Release
• Pectoralis Major Tears/Repairs
• Treatment of Throwing Injuries of the Shoulder
• Mumford Distal Clavicle Excision
• ORIF of the Clavicle Fractures
How to Prevent Shoulder Surgery Failure?
You can’t always prevent failed shoulder surgery. However, there are steps you can take to reduce the risk. Choose a skilled surgeon with experience in the procedure you need. If unsure, you can check patient reviews on websites.
Then, preparing before surgery, such as losing weight, quitting smoking, or improving your diet, can lower the risk of complications and help achieve better results. After surgery, follow the exercises your physiotherapist recommends you. They can aid your recovery. You must also listen to your surgeon’s advice on when it’s safe to resume normal activities, like work or driving.
Wrapping Up
The symptoms of failed shoulder surgery can affect a person’s quality of life and physical abilities. The outcome often depends on the type of surgery they had.
For example, a 2021 study shows that about 1 in 4 people who have had a shoulder replacement might need revision surgery at some point. Those aged 60 and under are four times more likely to need revision surgery than those over 85.
Also, revision surgery tends to have worse results than the original shoulder replacement, with a 50% higher chance of complications.
“A person’s outlook also depends on their symptoms and how much damage the joint has suffered. In some cases, symptoms might improve on their own with nonsurgical or surgical treatments.” States Dr. Michael C. Cusick.
