Prospective evaluation of clinical and radiologic factors predicting return to activity within 6 months after arthroscopic rotator cuff repair

J Shoulder Elbow Surg. 2015 Mar;24(3):439-45. doi: 10.1016/j.jse.2014.08.014. Epub 2014 Oct 16.

Abstract

Background: This study aimed to report the outcome of patients who underwent arthroscopic rotator cuff repair (ARCR) and to determine the factors associated with return to work and activity.

Materials: Three hundred sixty-five patients who underwent ARCR were prospectively evaluated. The cohort was divided into 2 groups based on clinical results at 6 months. Group A consisted of patients who were considered to have a satisfactory outcome based on return to their previous professional or spare-time activities. Group B consisted of patients with an unsatisfactory outcome based on a lack of return to normal work or activities.

Results: Of the patients, 305 had a satisfactory outcome (group A) and 60 were categorized as having an unsatisfactory outcome (group B). On multivariate analysis, preoperative factors associated with group B included female gender and heavy manual labor. Postoperative bursitis on ultrasound at 6 months was associated with being in group B. Lack of tendon healing was not associated with group B. However, if a patient without healing had persistent pain at 6 months, the pain persisted at 9 months.

Conclusion: ARCR is an effective procedure that leads to significant improvement in pain, function, and tendon healing in most cases. However, in 1 of 5 cases, patients were unable to resume normal activity at 6 months postoperatively. Persistent limitation at 6 months was associated with female gender, heavy manual workers, and the presence of postoperative persistent bursitis.

Keywords: Arthroscopic rotator cuff repair; double row; recovery of function; return to work; tendon non-healing or retear; treatment outcome; ultrasound; workers' compensation claim.

MeSH terms

  • Aged
  • Arthroscopy / rehabilitation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Radiography
  • Recovery of Function
  • Return to Work
  • Rotator Cuff / diagnostic imaging
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries
  • Suture Techniques
  • Tendon Injuries / diagnosis*
  • Tendon Injuries / rehabilitation
  • Tendon Injuries / surgery*
  • Treatment Outcome