Retear rates after rotator cuff surgery. a systematic review and meta-analysis
Introduction
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.
Methods
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.
Results
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).
Discussion
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.
Conclusion
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.