Rotator Cuff Repair Study Designs Correlate With Revision Shoulder Surgery Rates: A Systematic Review.

Purpose: To identify arthroscopic rotator cuff repair study groups and evaluate if study design or other study characteristics correlate with a repeat ipsilateral shoulder surgery.

Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases was conducted on March 20, 2021, and April 2, 2021. The following search terms were used by 2 different researchers: ((Rotator cuff repair[Title/Abstract]) AND (Revision[Title/Abstract]) NOT (Systematic Review[Title/Abstract]) NOT (arthroplasty[Title/Abstract]). All English-language studies published between 2002 and 2021 were manually reviewed for revision rate as a primary outcome of primary rotator cuff repair. Revision rate is defined as the percentage of primary rotator cuff repairs that underwent revision.

Results: Sixteen studies with 25 total treatment groups were included. Five Level IV studies and 11 Level III studies encompassed a total of 95,578 patients. Of these treatment groups, the revision rate was compared by the study style (prospective vs retrospective), sample size, time required to follow up, time to follow up, average age, and postoperative American Shoulder and Elbow Surgeons score. No significant difference was found between revision rates of retrospective and prospective studies. A significant correlation was found between time required to follow up and revision rate (.42, P = .0415).

Conclusions: In this study, we found that prospective and retrospective studies report similar revision rates after arthroscopic rotator cuff repairs. There was an association between longer follow-up and higher revision rate.

Clinical relevance: Prospective and retrospective studies yielding similar results is an important finding when showing the validity of retrospective studies. Understanding the positive correlation between a longer time for follow-up and a higher revision rate along with how age, postoperative American Shoulder and Elbow Surgeons scores, and average time to follow up correlate with revision rates is a useful consideration when designing studies and evaluating data.