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Prognostic Factors for Repair Integrity After Arthroscopic Rotator Cuff Repair: A Systematic Review and

Lieselotte Pichler¹, Mélody Mussard^1,2, Michael Oyewale^3,4

¹Department of Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland.

Orthopaedic Journal of Sports Medicine

|July 10, 2026

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This systematic review found that increased age, larger rotator cuff tear size, reduced acromiohumeral distance, fatty infiltration, and tear retraction are associated with higher rates of recurrent defects after arthroscopic rotator cuff repair (ARCR). These factors can help predict repair integrity.

Area of Science:

Orthopedic Surgery
Biomedical Engineering
Sports Medicine

Background:

Repair integrity is a key outcome measure following arthroscopic rotator cuff repair (ARCR).
Previous studies identified independent prognostic factors for repair integrity.
A comprehensive quantitative review summarizing these findings was lacking.

Purpose of the Study:

To synthesize published association estimates between prognostic factors and repair integrity after ARCR.
To provide a quantitative overview of factors influencing rotator cuff repair outcomes.
To identify key predictors of repair integrity in ARCR.

Main Methods:

Systematic review and random-effects meta-analysis of longitudinal studies (January 2014-March 2024).
Inclusion of studies with multivariate analyses and at least 6 months follow-up.

Keywords:

general muscle injuries prognostic factors repair integrity rotator cuff shoulder

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Conversion of association measures to correlation coefficients (r) for pooled analysis.

Main Results:

Analysis of 30 studies involving 13,161 patients.
High-quality evidence links increased age to higher recurrent defect rates (r = 0.02).
Moderate-quality evidence shows larger tear size (r = 0.35), reduced acromiohumeral distance (r = 0.32), increased supraspinatus fatty infiltration (r = 0.63), and greater tear retraction (r = 0.30) are associated with higher defect rates.

Conclusions:

Moderate- to high-certainty evidence supports five prognostic factors associated with higher recurrent defect rates after ARCR.
These factors include sociodemographic and diagnostic variables.
Findings can guide future prognostic research priorities in rotator cuff repair.