Spin in systematic reviews on patch-augmented rotator cuff repair: prevalence, predictors, and methodological...

Rotator cuff tears are a major cause of shoulder pain and dysfunction, and surgical repair is often complicated by the risk of retear, especially in patients with large, massive, revision tears and high-risk patients. Biologic or synthetic patch augmentation has emerged to reinforce repair and potentially reduce retears. Despite many systematic reviews (SRs) and meta-analyses (MAs) on patch-augmented versus non-augmented repair, concerns remain regarding study heterogeneity, outcome variability, and spin in interpretation and reporting, particularly in abstracts. This study assessed the methodological quality and abstract spin.

This SR was conducted in accordance with the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. On October 30, 2025, PubMed, Scopus, and Web of Science were searched for English-language SRs and MAs comparing patch- or graft-augmented versus non-augmented rotator cuff repair in clinical studies. Eligible reviews reported at least one clinical, patient-reported, or imaging-based outcome. Two reviewers independently performed duplicate study selection, data extraction, spin assessment, and methodological quality appraisal using Yavchitz et al's 9 severe spin types and AMSTAR-2.

Sixteen reviews and MAs were included in this study. Spin was identified in 81.3% (n = 13) of the abstracts. The types were 5 (62.5%), 3 (56.2%), and 8 (50.0%). Univariate analysis found no significant associations with the funding status (P = .36), quality (P = 1.00), or impact factor (P = .95). Each AMSTAR-2 flaw was associated with 61% more spin types (incidence rate ratio, 1.61; 95% confidence interval, 1.08-2.49; P = .02).

Spin is prevalent in the abstracts of SRs on patch augmentation for rotator cuff repair, regardless of funding or journal impact factor. Although spin was widespread, poor methodological quality was linked to a greater spin burden rather than its presence. These findings highlight the importance of critically appraising SRs, as spin may contribute to an overly favorable interpretation of the evidence and potentially influence clinical decision-making. Readers should interpret the conclusions cautiously and verify the claims against the full-text results.