Retear rates after rotator cuff surgery. a systematic review and meta-analysis
Rotator cuff retear (RCR) is a significant postoperative complication. This study aims to determine the incidence of RCR after surgical treatment at different time points and identify the main factors influencing postoperative rotator cuff (RC) healing.
A systematic review and meta-analysis were conducted following the PRISMA guidelines. The search was carried out in July 2020, using PubMed and Cochrane Library databases. Only level 1 and 2 clinical evidence studies were included. The association between timing of retear and follow-up time points were investigated using an inverse-variance method of pooling data.
The study included 31 articles. The percentage of RCR after surgery was 15% at 3 months follow-up, 21% at 3–6 months follow-up, 16% at 6–12 months follow-up, 21% at 12–24 months follow-up, 16% at follow-up longer than 24 months. The main factors influencing RC healing are both patient-related (i.e., age, larger tear size, fatty infiltration) and not patient-related (i.e., postoperative rehabilitation protocol, surgical techniques, and procedures).
The study found that the incidence of RCR varies over time, with the highest rates observed at 3-6 months and 12-24 months post-surgery. Patient-related factors such as age, tear size, and fatty infiltration significantly influence the healing process. Non-patient-related factors, including the postoperative rehabilitation protocol and surgical techniques, also play a crucial role in RC healing.
Postoperative RC healing is influenced by both patient-related and non-patient-related factors. Further high-level clinical studies are needed to provide highly relevant clinical results.
Prospective Randomized Controlled Studies or Meta-Analyses on Similar Subject Matter
The study incorporated data from level 1 and 2 clinical evidence studies, which include randomized controlled trials (RCTs) and prospective comparative studies. The meta-analysis approach allowed for the pooling of data from these studies to provide a comprehensive understanding of the incidence of RCR and the factors influencing RC healing. The study’s findings are therefore based on high-quality evidence, but the authors note the need for further high-level clinical studies to confirm and expand upon these results.