Risk factors for symptomatic retears after arthroscopic repair of full-thickness rotator cuff tears

Abstract

Background: Factors affecting a rotator cuff symptomatic retear after arthroscopic repair have yet to be clearly identified, since they usually influence the surgical decisions. Methods: Consecutive patients with full-thickness tear of the supraspinatus who underwent arthroscopic repair were retrospectively analyzed. Cases of symptomatic retear, defined as Sugaya type IV and V on magnetic resonance imaging, associated with intensive pain and/or functional impairment were identified at follow-up. The patients with no symptomatic retear were selected as the control group. Information from potential risk factors of symptomatic retear, including depression and subacromial corticosteroid injections, was extracted from the medical records. The statistical analysis included multivariant logistic regression. Results: The symptomatic retear rate was 9.5% in 158 patients. Patients in the symptomatic retear group were more likely to be smoking, to have massive tears, a short acromiohumeral distance, and moderate to severe fatty infiltration. They also had had more frequently subacromial corticosteroid injections and depression. However, following the multiple logistic regression analysis, only massive tears and moderate to severe fatty infiltration remained significantly associated. Similarly, in relation to the study hypothesis, both corticosteroid injections (odds ratio [OR] 6.66, 95% confidence interval [CI] 1.49, 29.81; P ¼ .013) and depression (OR 8.26, IC 1.04, 65.62; P ¼ .046) were significantly associated with symptomatic retear risk. Conclusions: This study found support for the hypothesis that both depression and corticosteroid infiltration before surgery are independent risk factors for symptomatic retear after arthroscopic repair of rotator cuff. The study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki, and the hospital ethical committee approved the study, to conform with Spanish law: Ethical Committee for Clinical Research in the CEIC idcsalud in Cataluña (Internal Code [study number]: 2016/49-COT-ASEPEYO).

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

“…In order to determine which patients may be good candidates for biological augmentation during RCrepairs, it is important to understand how patient demographics alter characteristics of CTPs, as this may affect healing. Patients who are old, obese, diabetic, and smoke have previously been reported to have higher rates of RC repair failures compared to healthy patients [32][33][34][35]. Muench et al was the first to demonstrate that SB CTPs demonstrated high proliferation potential regardless of patient demographics and RC tear characteristics [36].…”

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

“…After further reading the full text, according to the inclusion and exclusion criteria established in this study, 14 documents were finally included. 10,15,18,28,30,33,[35][36][37]39,40,44,46,53 The specific retrieval process and results are shown in Fig. 1.…”

“…Only 1 article 18 had an NOS score of 6, and the average NOS score was 7.7 points, which indicates that the quality of the included literature was very high. The literature quality evaluation details of the 14 included studies 10,15,18,28,30,33,[35][36][37]39,40,44,46,53 are shown in Supplementary Material S3.…”

“…Meta-analysis showed that rotator cuff retear was more likely with increasing body mass index (BMI) (WMD 0.52, 95% CI 0.23, 0.82; P < .001). A total of 7 studies 10,26,35,36,40,44,46,53 reported the impact of diabetes on rotator cuff healing. Meta-analysis showed that diabetes was a risk factor for retear after ARCR (OR 1.42, 95% CI 1.02, 1.97; P ¼ .04).…”

A bio-inductive collagen scaffold that supports human primary tendon-derived cell growth for rotator cuff repair

“…There are a number of risk factors reported in meta-analyses of outcomes of rotator cuff surgery that can contribute to a higher rate of re-tearing. These include age [ 55 ], size of the initial tear [ 56 ], level of post-surgical activity [ 57 ], prior corticosteroid administration [ 58 ], low HDL levels [ 59 ] as well as co-existent shoulder pathology or a fibro-inflammatory genotype of the repaired tendon [ 60 ] and further studies will be required to determine the causes of re-tearing following augmentation of RC repairs with BCS.…”