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Gender and degree of tendon healing are independent predictive factors for clinical outcome in successfully healed rotator cuff tears

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Arthroscopic rotator cuff repair (aRCR) is a commonly performed procedure and has been reported to be a successful treatment. Successful healing has traditionally been considered to be associated with good outcome; however, knowledge on predictive factors affecting final outcome other than tendon healing is limited. This study aims to investigate predictive factors influencing clinical outcome following aRCR in patients with successfully healed tears.

Methods

This retrospective case–control study was conducted in a single center with 135 patients who had successfully healed tendons based on Sugaya classification (grades I–III) on postoperative magnetic resonance imaging (MRI) scans following aRCR. Clinical outcome measures included Constant–Murley score (CMS), range of motion (ROM), pain score. Various preoperative, intraoperative factors and degree of postoperative tendon healing were assessed to identify independent predictive factors for final clinical outcome.

Results

Mean age of patients was 55.9 ± 9.0 years and mean follow-up duration was 46.8 ± 14.9 months. There were 50 (37%) male and 85 (63.0%) female patients. At final follow-up, mean CMS was 85.7 ± 12.0. Considering mean postoperative CMS and the minimal clinically important difference (MCID) of 10 points for CMS, a cutoff level of 75 points for CMS was set (85–10 = 75) and study population was divided into two study groups (group I, poor outcome, CMS ≤ ;75, and group II, good outcome, CMS > 75). There were 24 (17.8%) patients in group I and 111 (82.2%) patients in group II. Univariate analysis revealed that gender, body mass index (BMI) and degree of tendon healing (Sugaya classification) differed significantly between two groups (p < 0.05). Multivariate logistic regression analysis which was conducted with these variables showed that female gender (odds ratio 3.65) and Sugaya grade III (odds ratio 8.19) were independent predictive factors which were significantly associated with poor outcome (p < 0.05).

Conclusions

This study showed that despite achieving a successful healing, considerable amount of patients (17.8%) have ended up with poor outcome. Female gender and degree of tendon healing were identified as independent predictive factors for poor outcome. These data would help surgeons during decision-making, risk assessment and patient counseling.

Level of evidence

III.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey

    Koray Şahin

  2. Department of Orthopedics and Traumatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

    Muhammed Oğuzhan Albayrak & Ali Erşen

  3. Department of Orthopedics and Traumatology, Hendek State Hospital, Sakarya, Turkey

    Fatih Şentürk

  4. Department of Orthopedics and Traumatology, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey

    Mehmet Ersin

Authors
  1. Koray Şahin
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  2. Muhammed Oğuzhan Albayrak
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  3. Fatih Şentürk
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  5. Ali Erşen
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Corresponding author

Correspondence to Koray Şahin.

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IRB approval was obtained from institutional review board of Istanbul University Istanbul Faculty of Medicine with IRB ID number: E-67690154-050.03.04-1110453.

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Şahin, K., Albayrak, M.O., Şentürk, F. et al. Gender and degree of tendon healing are independent predictive factors for clinical outcome in successfully healed rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 31, 4585–4593 (2023). https://doi.org/10.1007/s00167-023-07508-7

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  • DOI: https://doi.org/10.1007/s00167-023-07508-7

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