title: Predictors of outcomes after rotator cuff repair-A meta-analysis.
abstract: METHODS
  Systematic review.
  
  
  BACKGROUND
  Clinical outcomes associated with rotator cuff repair (RCR) are generally favorable, but no study has attempted to establish a set of predictors that affect outcomes.
  
  
  OBJECTIVE
  This study aims to statistically analyze articles and establish a set of predictors that affect outcomes after RCR.
  
  
  METHODS
  An electronic literature search of multiple databases was conducted to identify studies that addressed prognosis after RCR. Quality ratings were conducted with a prognostic study evaluation tool. Summary data for predictors and outcomes were extracted, entered in comprehensive meta-analysis software, transformed where necessary, and pooled to allow for estimation of odds ratio for each predictor.
  
  
  RESULTS
  From 18 studies, 3 were high quality, 7 were moderate and 8 were low-quality studies. Fatty infiltration had a significant negative effect (OR = 9.3), whereas larger tear size, lower preoperative muscle strength (OR = 4.0), multiple tendon involvement (OR = 6.0), diabetes, and worker's compensation status (OR = 8.7) had a moderate negative effect on outcomes after RCR. Older age had a modest negative effect on cuff integrity at follow-up (OR = 2.8), but no significant effect on function. In addition, a history of trauma, smoking, and duration of symptoms before surgery had no significant effect on outcomes.
  
  
  CONCLUSIONS
  Injury to the cuff (body structure), physical impairment, personal factors and social factors affects outcomes; although the importance of predictors varies between anatomic and functional outcomes.
  
  
  CONCLUSIONS
  A multifactorial biopsychosocial prognosis should be considered in management.
  
  
  METHODS
  Level 2.
authors.affiliation: School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: jpraman@gmail.com.
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Raman
authors.affiliation: School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Walton
authors.affiliation: School of Physical Therapy, Western University, London, Ontario, Canada; Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
authors.forename: Joy C
authors.initials: JC
authors.lastname: MacDermid
authors.affiliation: Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
authors.forename: George S
authors.initials: GS
authors.lastname: Athwal
keywords: Meta-analysis; Prognosis; Rotator cuff repair; Rotator cuff tear