Risk Factors Associated with Self-Removal of Shoulder Braces After Rotator Cuff Repair

Background: Rotator cuff repair is a widely performed surgery, with the re-tear rate reportedly above 20%. To protect the repair site, patients are instructed to wear braces for 4-6 weeks, but the compliance is known to be poor. This study aimed to identify the risk factors for poor compliance and to determine whether poor compliance leads to complications such as re-tears. Additionally, we planned to determine the patients’ subjective factors for self-removal of the brace.Method: This study included 101 patients who underwent rotator cuff repair between June 2019 and August 2020. The patients could select from two types of braces, namely, the sling-type and hard-type abduction brace. They were then instructed to wear the brace for 6 weeks postoperatively. During the follow-up, ultrasonography was performed to evaluate the repair site, and a questionnaire was administered to evaluate the compliance. Result: The participants were categorized into three groups (Groups A, B, and C) according to the degree of self-removal. Compliance was found to be poor, and only 35 patients met the standard of Group A. There were no statistically significant patient factors affecting the compliance. Re-tears were noted in 4 patients. Only the surgery type (open versus arthroscopic surgery) was a statistically significant factor for re-tears. Among the subjective factors, discomfort while sleeping was the most common complaint and the most common reason for the actual removal of the brace.Conclusion: Although the risk factors for self-removal of the braces could not be identified clearly and statistically, catastrophic re-tears requiring re-operation were observed in patients with poor compliance. For better compliance, the postoperative guidelines and education of the patients should be reviewed. Furthermore, the braces need to be modified to a more comfortable design.