Article

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.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS