Clinical outcomes in patients with retear after arthroscopic rotator cuff repair: A meta-analysis

Background: Rotator cuff retear is a major concern after arthroscopic rotator cuff repair (ARCR); however, the effects of retear remain unclear. Therefore, the purpose of this study was to assess the clinical outcomes of postoperative retear and intact tendons after ARCR. Methods: We searched PubMed, Cochrane Library, Scopus, and PEDro databases for studies performed from January 2000 to June 2020. Clinical outcomes included the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles shoulder (UCLA) score, pain score, range of motion, and muscle strength. Meta-analysis using random-effects models was performed on the pooled results to determine significance. Results: The initial database search yielded 3141 records. After removal of duplicates, 26 of which met the inclusion criteria. Patients in the retear group had significantly lower Constant score [- 8.51 points (95% CI, - 10.29 to - 6.73); P < 0.001], ASES score [- 12.53 points (95% CI, - 16.27 to - 8.79); P < 0.001], UCLA score [- 3.77 points (95% CI, - 4.72 to - 2.82); P < 0.001], and significantly higher pain score [0.56 cm (95% CI, 0.10 to 1.01); P = 0.02] than the intact group. In addition, the retear group had significantly lower flexion [- 10.46 degrees (95% CI, - 19.86 to - 1.07); P = 0.03], abduction [- 14.84 degrees (95% CI, -28.55 to - 1.14); P = 0.03], and external rotation [- 7.22 degrees (95% CI, - 13.71 to - 0.74); P = 0.03] range of motion, and flexion [- 1.65 kg.f (95% CI, - 2.29 to - 1.01); P < 0.001], abduction [- 1.87 kg.f (95% CI, - 3.02 to - 0.72); P = 0.001], and external rotation [- 1.66 kg.f (95% CI, - 3.25 to - 0.07); P = 0.04] muscle strength. Conclusion: Our results suggest that retear after ARCR leads to poor clinical outcomes after surgery. (C) 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.