Predicted healing rates do not correlate with patient outcomes following rotator cuff repair-A minimum 2-year follow-up.

Abstract

The Rotator Cuff Healing Index (RoHI) predicts healing rates following rotator cuff repair based on patient- and tear-specific risk factors and has subsequently been suggested as a means of predicting which high-risk patients might benefit from the use of repair augmentation. However, the correlation between predicted healing rates and functional outcomes is unclear. The aim of this study was to evaluate the relationship between predicted healing rates based on the RoHI and patient-reported outcomes (PROMs) at minimum 2-years following rotator cuff repair. Patients undergoing superior rotator cuff repair, supraspinatus with or without concurrent infraspinatus repair, by a single surgeon between 2019 and 2022 with a minimum 2-year follow-up were included. Modified RoHI scores were retrospectively calculated using preoperative imaging. Patients were divided into four groups based on RoHI scores (≤4, 5-6, 7-9, and ≥10) and into two groups for further analysis (RoHI <7 and RoHI ≥7). PROMs [the American Shoulder and Elbow Surgeons score (ASES) and the University of California Los Angeles (UCLA) score] were compared preoperatively and at 2 years postoperatively. Statistical significance was set at p ​< ​0.05. A total of 94 patients met the inclusion criteria. All groups demonstrated significant improvements in the ASES and the UCLA scores from preoperative to 2-year follow-up, RoHI <4 group ASES 33.58 to 87.88 (p ​< ​0.0001), UCLA score 15.45 to 32.26 (p ​< ​0.0001); RoHI 5-6 group ASES 45.88 to 93.29 (p ​< ​0.0001), UCLA score 16.06 to 22.12 (p ​< ​0.0001); RoHI 7-9 group ASES score 34.00 to 87.00 (p ​< ​0.0001), UCLA score 15.277 to 31.53 (p ​< ​0.0001); RoHI ≥10 group ASES score 41.00 to 90.00 (p ​= ​0.0014), UCLA score 13.50 to 33.17 (p ​= ​0.0004). Mean 2-year PROMs were not statistically different across all RoHI groups. Likewise, patients in the RoHI <7 and RoHI ≥7 groups demonstrated no statistical difference in outcomes at 2 years (ASES, p ​= ​0.68; UCLA, p ​= ​0.56). Patients achieve similar and significant improvements in PROMs at 2 years following rotator cuff repair without augmentation regardless of predicted healing rates. Retrospective series; level of evidence, 4.