title: The Clinical Effect of a Rotator Cuff Retear: A Meta-analysis of Arthroscopic Single-Row and Double-Row Repairs.
abstract: The clinical effect of a retear after rotator cuff repair remains unclear. While some studies have indicated clinical deficits due to a retear, others have stated that a retear does not detrimentally affect outcomes.
  
  
  
  To conduct a meta-analysis comparing clinical outcomes between intact and retorn rotator cuffs after arthroscopic repair.
  
  
  
  Meta-analysis.
  
  
  
  A literature search using the terms "arthroscopic," "rotator cuff," "repair," "retear," "re-tear," "defect," "single-row," "double-row," "clinical outcomes," and "functional outcomes" was conducted. Article inclusion criteria were an adequate description of the surgical technique, stratification of outcomes by intact rotator cuff versus retear with a minimum of 1 year of follow-up, and documentation of the presence/absence of a full-thickness retear using imaging. Exclusion criteria were isolated subscapularis tears/repairs, labral repairs, infections, postoperative fractures, insufficient data or statistical indications, and postoperative data not stratified by retear versus intact rotator cuff. A meta-analysis was performed using a random-effects model on variables that had comparisons from at least 3 studies. Single-row (SR) and double-row (DR) studies were analyzed both separately and together in an "all arthroscopic repairs" (AAR) comparison. The calculated effect was considered significant at a P value <.05.
  
  
  
  Within the SR group, patients with a rotator cuff retear had a significantly lower Constant score (mean difference [95% CI], -6.79 [-8.94 to -4.65]; P < .001) and lower University of California, Los Angeles (UCLA) score (-3.21 [-5.27 to -1.15]; P = .002) but not higher pain (0.071 [-0.34 to 0.49]; P = .739). Within the DR group, patients with a rotator cuff retear had a significantly lower Constant score (mean difference [95% CI], -9.35 [-12.2 to -6.50]; P < .001), lower American Shoulder and Elbow Surgeons (ASES) score (-12.1 [-17.1 to -7.26]; P < .001), lower UCLA score (-3.07 [-4.85 to -1.29]; P < .001), higher pain (0.622 [0.19 to 1.05]; P = .005), and lower abduction strength ( P < .001). In the AAR comparison, patients with a retear had a significantly lower Constant score (mean difference [95% CI], -7.56 [-9.55 to -5.57]; P < .001), lower ASES score (-10.1 [-15.5 to -4.64]; P < .001), lower UCLA score (-3.00 [-4.47 to -1.53]; P < .001), and lower abduction strength (in kg·f) (-3.32 [-4.53 to -2.12]; P < .001) but not higher pain (0.332 [-0.014 to 0.680]; P = .060).
  
  
  
  Patients with a full-thickness rotator cuff retear exhibited significantly lower clinical outcome scores and strength compared with patients with an intact or partially torn rotator cuff.
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, Michigan, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yang
authors.affiliation: Orthopaedic Research Laboratories, Beaumont Health System, Royal Oak, Michigan, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Robbins
authors.affiliation: Orthopaedic Research Laboratories, Beaumont Health System, Royal Oak, Michigan, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Reilly
authors.affiliation: Orthopaedic Research Laboratories, Beaumont Health System, Royal Oak, Michigan, USA.|Department of Orthopaedic Surgery, William Beaumont School of Medicine, Oakland University, Rochester, Michigan, USA.
authors.forename: Tristan
authors.initials: T
authors.lastname: Maerz
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, Michigan, USA.|Department of Orthopaedic Surgery, William Beaumont School of Medicine, Oakland University, Rochester, Michigan, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Anderson
mesh_terms: D001182:Arthroscopy; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D012008:Recurrence; D017006:Rotator Cuff / Q000502:physiology / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: arthroscopic rotator cuff repair; clinical outcomes; meta-analysis; retear; rotator cuff tear