Prognosis Factors for Successful Recovery after Arthroscopic Rotator Cuff Repair
Rotator Cuff (RC) tear is a common shoulder disorder. Prevalence ranges from 13% in people over 50 to 50% in those over 80. It has been reported, that at least one-third of people with a RC tear tend to be symptomatic and suffer from pain, weakness and limited range of motion. For this group of people RC tears may lead to restriction in activities of daily living and surgical repair of the RC with an arthroscopic procedure can be a potential solution.
Extent and duration of recovery for patients after an arthroscopic RC repair has been reported to vary. A recent systematic review has been completed to review prognostic factors for successful recovery. The review included published articles from 1995 to November 2013 reporting on prognostic factors for recovery after arthroscopic rotator cuff repair. 455 studies were identified and 10 were included in the final review. In the studies reviewed, complete tendon healing at final assessment ranged from 60 to 88%. The following 12 factors were identified as being predictive for a successful outcome.
- Demographic Factors Younger age (less than 50 to 55)
Male gender
- Clinical Factors Higher bone mineral density
Absence of diabetes mellitus
Higher level of sports activity
Greater pre operative range of motion
Absence of obesity
- Cuff Integrity Smaller sagittal size cuff lesion
Less retraction of the cuff
Less fatty infiltration
No multiple tendon involvement
- Surgical Procedure No concomitant biceps or AC joint procedures
Strongly predictive and less predictive factors were not identified with this study.
Individuals undergoing arthroscopic RC repair can positively influence their chance of successfully outcome by working on pre operative range of motion, activity level and general health. As health professionals, when recommending arthroscopic RC surgery, timing of the surgery should be considered, as an individual’s age, retraction of the cuff and fatty infiltrates play a role in post operative success.
Fermont A, Wotherbeck R, Wessel RN, Baeynes JP, de Bei R. Prognostic Factors for Successful Recovery After Arthroscopic Rotator Cuff Repair: A Systematic Literature Review. J Orthop Sports Phys Ther 2014;44(3):153-163.