SynthesisBMC musculoskeletal disorders2026
Patient-specific risk factors for repair failure and poor functional outcome after rotator cuff repair - an umbrella review.
Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association between in-hospital nursing workload and early functional recovery after unilateral arthroscopic rotator cuff repair: a retrospective cohort study.Frontiers in physiology · 2026Article
- Latent class analysis-derived prediction model of shoulder function after arthroscopic repair for rotator cuff tear: a large retrospective cohort study.Frontiers in surgery · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
purposeUnderstanding patient-specific factors that influence postoperative outcomes and failure rates following rotator cuff repair is crucial for surgeons to tailor individualized treatments. The purpose of this umbrella review was to identify preoperatively measurable factors that influence the risk of retear and functional outcomes following rotator cuff repair (RCR). Additionally, the study aimed to evaluate the quality of evidence from systematic reviews and meta-analyses to provide a comprehensive understanding of these predictive factors.
methodsA systematic search of the MEDLINE database via PubMed was conducted to identify systematic reviews and meta-analyses reporting preoperatively measurable factors affecting functional outcomes and failure rates following arthroscopic rotator cuff repair. The methodological quality of included reviews was assessed using the AMSTAR checklist. Data synthesis summarized key risk factors, quantified study overlap via Corrected Covered Area (CCA), and examined heterogeneity and publication bias when reported in the reviews.
resultsTwenty-three systematic reviews, including 11 meta-analyses, met the inclusion criteria, yielding a CCA of 0.403, which reflects moderate overlap. The average AMSTAR score was 7.57, indicating moderate methodological quality. However, only a few reviews included analyses of heterogeneity or publication bias, and the evidence presented was often contradictory. Meta-analyses revealed statistically significant associations between higher retear rates and factors such as advanced age, reduced bone mineral density, elevated body mass index, diabetes, shorter acromiohumeral interval, increased critical shoulder angle, involvement of multiple tendons, greater tendon retraction, longer symptom duration, larger tear size, poor tissue quality, and greater distance from the musculotendinous junction to the glenoid. Genetic analyses provided moderate to strong evidence linking healing failure to mutations in the matrix metallopeptidase 3 (MMP3) and Tenascin C (TNC) genes, as well as a single nucleotide polymorphism (SNP) in the Estrogen Related Receptor β (ESRRβ) gene. Improved tendon healing was associated with the upregulation of the growth factor Bone Morphogenetic Protein 5 (BMP5) and increased expression of collagen type III (COL3). High preoperative expectations consistently correlated with better functional outcomes, whereas other psychological factors, such as concerns and fear avoidance, were associated with poorer outcomes.
conclusionEvidence synthesized in this review underscores the importance of patient age, expectations, and the extent of the rotator cuff tear in influencing outcomes following rotator cuff repair. These factors should be carefully considered in treatment planning for patients undergoing rotator cuff repair.
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