Scientific/Clinical Article| Volume 30, ISSUE 3, P276-292, July 2017

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Predictors of outcomes after rotator cuff repair—A meta-analysis

Published:February 22, 2017DOI:


      Study Design

      Systematic review.


      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.


      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.


      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.


      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.


      A multifactorial biopsychosocial prognosis should be considered in management.

      Level of Evidence

      Level 2.


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      JHT Read for Credit

      Quiz: #488

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        Data was collected via
        • a.
          patient interviews
        • b.
          manual chart reviews
        • c.
          electronic literature search
        • d.
          library literature search
      • #2.
        A very significant factor in predicting poor outcomes was
        • a.
          fatty infiltration
        • b.
          patient age
        • c.
          lesion on dominate arm
        • d.
          open vs. closed surgical technique
      • #3.
        Which factors were not significant in predicting outcomes
        • a.
          a history of trauma
        • b.
        • c.
          duration of symptoms
        • d.
          all of the above
      • #4.
        The study methodology was based on
        • a.
          only RCTs
        • b.
          only qualitative reports
        • c.
          pooled data
        • d.
          ASHT guidelines
      • #5.
        The authors suggest that we need more RCTs studies in the future
        • a.
        • b.
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