Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review

Abstract

Background: Retear after arthroscopic rotator cuff repair (ARCR) consistently challenges medical staff and patients, and the incidence of retear after surgery is 10%-94%. The purpose of this study was to identify the risk factors that cause retear after ARCR and provide theoretical guidance for clinical intervention to reduce the occurrence of postoperative rotator cuff retear. Methods: The protocol for this meta-analysis was registered with PROSPERO (CRD42021225088). PubMed, Web of Science, and Embase were searched for observational studies on risk factors for rotator cuff retear after arthroscopic repair. Meta-analytical methods were used to determine the odds ratio or weighted mean difference of potential risk factors related to postoperative rotator cuff retear. Stata 15.1 was used to quantitatively evaluate the publication bias of the statistical results. Results: Fourteen studies from 6 countries with a total of 5693 patients were included. The meta-analysis revealed that the risk factors for retear after rotator cuff repair were age, body mass index, diabetes, subscapularis and infraspinatus fatty infiltration, symptom duration, bone mineral density, tear length, tear width, tear size area, amount of retraction, critical shoulder angle, acromiohumeral interval, distance from the musculotendinous junction to the glenoid, operative duration, biceps procedure, and postoperative University of California Los Angeles shoulder score. Conclusion: These findings can help clinical medical staff identify patients who are prone to retear early after arthroscopic repair and develop targeted prevention and treatment strategies for modifiable risk factors, which are of great significance for reducing the occurrence of rotator cuff retear after ARCR.

Analysis of Patient Factors Affecting In Vitro Characteristics of Subacromial Bursal Connective Tissue Progenitor Cells during Rotator Cuff Repair

“…Specific patient demographics and comorbidities have long been associated with RC repair failure, such as advancing age [45,46], smoking [38,[47][48][49][50], diabetes mellitus [51][52][53][54], and obesity [33,55,56], among others [41,57]. When deciding which patients may be good candidates for bursal biological augmentation of RC repairs, these demographics may concern orthopaedic surgeons that their tissue may not be viable.…”

Added value of combined acromiohumeral distance and critical shoulder angle measurements on conventional radiographs for the prediction of rotator cuff pathology

“…Hence, at optimal cut-off values PI AHD-CSA allows to maintain good specificity of both AHD and CSA but add substantial sensitivity to the diagnosis of RCT or CFD. With respect to existing literature, this may be the main benefit of a quantitative formula over mere qualitative interpretation of the two different quantitative measures CSA and AHD, as the two parameters have been validated as independent risk factors, but both lack the ability to screen for disease due to the large percentage of false negatives when cut-off values are used that offer a somewhat good specificity [21] , [22] .…”

A high acromion-greater tuberosity impingement index increases the risk of retear after arthroscopic rotator cuff repair

“…19 The overall retear rate was 26.0%, similar to the rates in previous studies of 10–48.4%. 20 The causes of rotator cuff retear are unclear. Several prognostic factors affect postoperative healing after ARCR, including the patient’s age, initial tear type and size, fatty infiltration of muscle, degree of tendon retraction, repair technique and rehabilitation.…”