Correlation between oxidative stress level and clinical outcome in rotator cuff injury patients

To investigate the relationship between oxidative stress (OS) and clinical outcome in patients with rotator cuff injury (RCI).

Eighty-two surgically treated RCI patients (May 2022-February 2025) were enrolled in this retrospective study. All participants underwent arthroscopic rotator cuff repair and were further grouped into a good prognosis group (n=39) or a poor prognosis group (n=43) based on the University of California, Los Angeles (UCLA) Shoulder Rating Scale (UCLA ≥29 vs. UCLA <29). Relevant clinical details like age, sex, tear area, disease duration, injury pattern, and UCLA scores, were collected. Serum samples were tested pre- and postoperatively for the quantification of OS biomarkers: reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx). Pearson correlation analysis was used to evaluate the association between OS biomarkers and UCLA scores. Receiver operating characteristic (ROC) curve analysis was used to assess their predictive value for clinical outcomes. Prognostic determinants were identified using univariate and multivariate logistic regression analyses.

ROS and MDA concentrations were markedly elevated in poor-prognosis patients compared to favorable-prognosis individuals, whereas SOD and GPx activities were reduced. Surgical intervention significantly elevated the levels of SOD and GPx, and reduced the levels of ROS and MDA. Correlation analyses linked higher UCLA scores to elevated ROS/MDA levels and reduced SOD/GPx activity. ROC curve analysis showed that the predictive accuracy (area under the curve [AUC]) for individual OS biomarkers ranged from 0.750-0.810, which was markedly improved (AUC=0.939) when used in combination. Univariate and multivariate logistic regression analysis further identified ROS, MDA, SOD, and GPx as independent factors influencing clinical prognoses in RCI patients.

OS levels can serve as a key determinant of clinical outcome in RCI patients.