Predictive Factors of Rotator Cuff Retear After Arthroscopic Repair Based on Preoperative Shoulder Ultrasonography.

Abstract

Purpose: This study aimed to identify independent predictors of rotator cuff retear and to develop a predictive model using preoperative ultrasonography data.

Methods: A retrospective analysis of 215 patients (219 shoulders) who underwent arthroscopic rotator cuff repair (ARCR) for supraspinatus tendon tears was conducted. Retears were defined using the Sugaya classification confirmed by MRI. Clinical and preoperative ultrasonography data were evaluated, and a logistic regression model was developed for predicting rotator cuff retear based on preoperative ultrasonography, and a receiver operating characteristic curve was used to assess the predictive capability.

Results: The retear rate was 16.9% in our enrolled 219 cases. A significant difference was found between the intact and retear groups in age, tear size, stages of supraspinatus tendon retraction, osseous changes, concurrent infraspinatus tendon tears, and Heckmatt scale scores for both supraspinatus and infraspinatus muscles in univariate analysis. Multivariate regression identified the Heckmatt scale score of the infraspinatus muscles and the supraspinatus tendon retraction stage as independent predictors of postoperative rotator cuff retear. The prediction model's area under the curve was 0.909 (95% CI: 0.863-0.944).

Conclusion: Preoperative ultrasonography provides a reliable tool for predicting postoperative retears in ARCR patients. High-risk findings (supraspinatus tendon retraction beyond Stage 2 and infraspinatus muscle Heckmatt scales exceeding Grade 2) should guide personalized surgical and rehabilitation strategies.