25dkou320 10.3205/25dkou320 urn:nbn:de:0183-25dkou3202 Meeting Abstract Kraus Kraus Moritz M

Abteilung für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Zürich, Schweiz Klinik für Traumatologie, Universitätsspital Zürich, Zürich, Schweiz

author Schneller Schneller Tim T

Abteilung für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Zürich, Schweiz

author Lazaridou Lazaridou Asimina A

Abteilung für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Zürich, Schweiz

author Scheibel Scheibel Markus M

Abteilung für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Zürich, Schweiz Center for Musculoskeletal Surgery (CMSC), Charité – Universitätsmedizin, Berlin, Deutschland

author Endell Endell David D

Abteilung für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Zürich, Schweiz

author German Medical Science GMS Publishing House

Düsseldorf

610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 320 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Schulter Rotatorenmanschette Berlin 20251028 20251031 AB48-4122 TextObjectives and questions: Rotator cuff re-tears (RCRT) present diagnostic and therapeutic challenges with multifactorial causes. This study categorizes re-rupture etiology in patients undergoing arthroscopic revision and evaluates failure characteristics using preoperative MRI and standardized arthroscopic imaging.Material and methods: Institutional registry data from 56 patients with posterosuperior RCRT undergoing arthroscopic revision were analyzed. Re-tears were classified as traumatic or degenerative based on history. Preoperative MRI was assessed using the Sugaya classification by two independent reviewers and compared with intraoperative findings. Suture-anchor construct failure and tendon healing were evaluated. Four failure types were defined: Type I: Footprint failure with suture-anchor construct failure, Type II: Footprint failure with intact suture material, Type III: Medial failure with intact footprint and suture material, Type IV: Medial failure with intact footprint and non-intact suture material. Interrater reliability (IRR) was analyzed using Cohen’s Kappa.Results: The cohort had a mean age of 57±10 years, 70% were male. 66% of re-ruptures were atraumatic, 30% trauma-related, 4% caused by postoperative infection. The mean interval between the primary surgery and revision was 26±35 months, 38% of cases were classified as Type II failure, 29% were Type I, 20% Type III, 7% Type IV, 6% of cases could not be classified due to insufficient intraoperative documentation. A complete re-reconstruction was achieved in 92% of cases, with double-row (DR) techniques used most frequently (68%). 35% of DR cases used 2 medial and 2 lateral anchors. 33% used 2 medial and 1 lateral anchor. Patch augmentation (xenograft or autograft) was performed in 11%. Side-to-side sutures were sufficient in 13%, while single-row reconstruction was used in 11%. Partial re-reconstruction with superior capsular reconstruction (SCR) was performed in 4%. Latissimus dorsi tendon transfer was performed in 2%, and reconstruction was not possible in another 2%. MRI-based evaluation of RCRT patterns showed: 4% Sugaya Type I, 11% Sugaya Type II, 22% Sugaya Type III, 63% Sugaya Type IV (IRR: kappa = 0.181). The MRI findings often underestimated intraoperative severity. The newly defined failure types demonstrated an IRR of kappa = 0.266.Discussion and conclusions: Preoperative MRI-based Sugaya classification often underestimates the severity of RCRT. Footprint failures (Types I–II) were the most common failure mechanisms. Re-reconstruction was achieved in nearly all cases. The differentiated classification of failure mechanisms (Types I–IV) showed improved IRR compared to the Sugaya classification and provides a systematic framework for understanding RCRT etiology and characteristics, enabling more targeted surgical strategies. 0 0 0 0