Jayaprakash Raman1, David Walton2, Joy C MacDermid3, George S Athwal4. 1. School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: jpraman@gmail.com. 2. School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada. 3. School of Physical Therapy, Western University, London, Ontario, Canada; Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada. 4. Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
Abstract
STUDY DESIGN: Systematic review. INTRODUCTION: Clinical outcomes associated with rotator cuff repair (RCR) are generally favorable, but no study has attempted to establish a set of predictors that affect outcomes. PURPOSE OF STUDY: This study aims to statistically analyze articles and establish a set of predictors that affect outcomes after RCR. METHODS: An electronic literature search of multiple databases was conducted to identify studies that addressed prognosis after RCR. Quality ratings were conducted with a prognostic study evaluation tool. Summary data for predictors and outcomes were extracted, entered in comprehensive meta-analysis software, transformed where necessary, and pooled to allow for estimation of odds ratio for each predictor. RESULTS: From 18 studies, 3 were high quality, 7 were moderate and 8 were low-quality studies. Fatty infiltration had a significant negative effect (OR = 9.3), whereas larger tear size, lower preoperative muscle strength (OR = 4.0), multiple tendon involvement (OR = 6.0), diabetes, and worker's compensation status (OR = 8.7) had a moderate negative effect on outcomes after RCR. Older age had a modest negative effect on cuff integrity at follow-up (OR = 2.8), but no significant effect on function. In addition, a history of trauma, smoking, and duration of symptoms before surgery had no significant effect on outcomes. DISCUSSION: Injury to the cuff (body structure), physical impairment, personal factors and social factors affects outcomes; although the importance of predictors varies between anatomic and functional outcomes. CONCLUSIONS: A multifactorial biopsychosocial prognosis should be considered in management. LEVEL OF EVIDENCE: Level 2.
STUDY DESIGN: Systematic review. INTRODUCTION: Clinical outcomes associated with rotator cuff repair (RCR) are generally favorable, but no study has attempted to establish a set of predictors that affect outcomes. PURPOSE OF STUDY: This study aims to statistically analyze articles and establish a set of predictors that affect outcomes after RCR. METHODS: An electronic literature search of multiple databases was conducted to identify studies that addressed prognosis after RCR. Quality ratings were conducted with a prognostic study evaluation tool. Summary data for predictors and outcomes were extracted, entered in comprehensive meta-analysis software, transformed where necessary, and pooled to allow for estimation of odds ratio for each predictor. RESULTS: From 18 studies, 3 were high quality, 7 were moderate and 8 were low-quality studies. Fatty infiltration had a significant negative effect (OR = 9.3), whereas larger tear size, lower preoperative muscle strength (OR = 4.0), multiple tendon involvement (OR = 6.0), diabetes, and worker's compensation status (OR = 8.7) had a moderate negative effect on outcomes after RCR. Older age had a modest negative effect on cuff integrity at follow-up (OR = 2.8), but no significant effect on function. In addition, a history of trauma, smoking, and duration of symptoms before surgery had no significant effect on outcomes. DISCUSSION: Injury to the cuff (body structure), physical impairment, personal factors and social factors affects outcomes; although the importance of predictors varies between anatomic and functional outcomes. CONCLUSIONS: A multifactorial biopsychosocial prognosis should be considered in management. LEVEL OF EVIDENCE: Level 2.
Authors: Paul S Micevych; Ankur Garg; Lucas T Buchler; Guido Marra; Matthew D Saltzman; Todd B Parrish; Amee L Seitz Journal: Skeletal Radiol Date: 2018-10-17 Impact factor: 2.199
Authors: Bong-Jae Jun; Sambit Sahoo; Peter B Imrey; Andrew R Baker; Ahmet Erdemir; Yuxuan Jin; Joseph P Iannotti; Vahid Entezari; Eric T Ricchetti; Michael J Bey; Kathleen A Derwin Journal: JSES Int Date: 2020-09-12
Authors: Laurent Audigé; Heiner C C Bucher; Soheila Aghlmandi; Thomas Stojanov; David Schwappach; Sabina Hunziker; Christian Candrian; Gregory Cunningham; Holger Durchholz; Karim Eid; Matthias Flury; Bernhard Jost; Alexandre Lädermann; Beat Kaspar Moor; Philipp Moroder; Claudio Rosso; Michael Schär; Markus Scheibel; Christophe Spormann; Thomas Suter; Karl Wieser; Matthias Zumstein; Andreas M Müller Journal: BMJ Open Date: 2021-04-22 Impact factor: 2.692