Review ArticleSpecific patient-related prognostic factors for rotator cuff repair: a systematic review
Section snippets
Literature search
A search of the literature in PubMed (from 1948 onward), EMBASE (from 1947 onward), PEDro (from 1929 onward), and the Cochrane Central Register of Controlled Trials was conducted to identify relevant publications until July 2013, without language restrictions. The literature search strategy for PubMed is presented in Table I.
Study selection and quality assessment
The publications had to meet the following selection criteria:
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Study design: prospective studies that describe prognostic factors affecting outcome in primary RCR. Studies
Age
Mean age of the patients ranged from 52 to 59.5 years (overall range, 32-80 years). The prognostic importance of age on functional outcome was assessed in 1 high-quality study and 6 medium-quality studies.1, 9, 10, 14, 15, 19, 28 None of the studies showed that age had a significant influence on functional outcome. We conclude that there is insufficient evidence that age has an influence on functional outcome.
Age was assessed in 3 medium-quality studies to determine its influence on cuff
Discussion
Many articles have described prognostic factors for RCR; yet there are conflicting results, and adequate statistical analysis (e.g., multivariate regression analysis) is not always performed. This systematic review was designed to identify patient-specific prognostic factors influencing functional and radiologic outcome after RCR and summarizes the evidence available up to now.
Possible side effects of RCR are increased pain, re-tear, and stiff shoulder; less common are infection, implant
Conclusions
Indications for repair of nontraumatic RCT as part of a degenerative entity are not always evident. So far, no systematic review has described patient-specific prognostic factors for RCR. Selection of appropriate patients for surgery should prevent unsatisfactory postoperative results, reducing adverse events and health care costs.
Considering the available evidence as summarized in this review, performance of RCR should be carefully considered in patients from older age groups as well as in
Acknowledgment
The authors wish to thank Truus van Ittersum for her help in developing search strategies for the electronic databases used.
Disclaimer
The authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
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2022, European Journal of Radiology OpenCitation Excerpt :The rate of complication after arthroscopy is approximately 11% [57], and the most common cause of failure is poor healing of repaired tissue, leading to suture pull out (Fig. 20) [58]. Risk factors for failure to heal include massive RCT involving multiple tendons, large size of tear, age > 65 years, muscle atrophy, retraction of torn tendon medial to the glenoid, and concomitant repair of other shoulder structures [59,60]. A “massive” rotator cuff tear is present if there is rupture of least two of the four rotator cuff tendons and/or retraction away from the attachment site of > 5 cm and should be described in the report (Fig. 21) [46].