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Kim, Bae, and Cho: Return to Sports Following Rotator Cuff Repair: A Systematic Review and Meta-Analysis
Review Article

The Korean Journal of Sports Medicine 2019; 37(4): 121-129.

Published online: 6 December 2019

DOI: https://doi.org/10.5763/kjsm.2019.37.4.121

Return to Sports Following Rotator Cuff Repair: A Systematic Review and Meta-Analysis

Du-Han Kim, Ki-Cheor Bae, Chul-Hyun Cho

Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.

Correspondence: Chul-Hyun Cho. Department of Orthopedic Surgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea. Tel: +82-53-258-7924, Fax: +82-53-258-4773, oscho5362@dsmc.or.kr

Received 7 October 2019       Revised 13 November 2019       Accepted 15 November 2019

Copyright © 2019 The Korean Society of Sports Medicine

The Korean Society of Sports Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Given the increasing common use of rotator cuff repair (RCR), return to sport (RTS) remains an important challenge and measure of success for athletes undergoing RCR. To determine the rate of return to the same level of sports after repair of rotator cuff tears.

Methods

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis of the results in the literature. The electronic databases of PubMed, Embase, Cochrane Library, and Scopus were used for the literature search. Study quality was evaluated according to the MINORS (Methodological Index for Nonrandomized Studies) checklist. Studies evaluating the rate of return to the same level of sports after repair of partial- or full-thickness rotator cuff tears were included.

Results

Ten studies were reviewed, including 357 patients who were treated with RCR and who had a mean follow-up of 48.1 months (range, 16–74 months). The overall rate of RTS was 88.6%. Among them, 77.9% (95% confidence interval [CI], 67.1%–86.0%) of patients were able to return to the same level of sports according to the meta-analysis. Subgroup meta-analysis revealed that partial-thickness rotator cuff tear was 77.9% (95% CI, 70.0%–84.1%), and full-thickness was 69.6% (95% CI, 46.3%–85.9%), but there was no statistical significance (p>0.05).

Conclusion

Most patients (88.6%) were able to return to sports after RCR and 78% of patients return to sports at the same level of play as before their injury.

Keywords: Arthroscopy, Athletes, Meta-analysis, Return to sports, Rotator cuff, Systematic review

Figures and Tables

Fig. 1

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. RTS: return to sport, RCR: rotator cuff repair.

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Fig. 2

Forest plot chart of the combine rate of return to sports at the same level of play as before injury. CI: confidence interval.

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Fig. 3

Funnel plot chart evaluating publication bias.

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Fig. 4

Forest plot chart of subgroup meta-analysis comparing return to sports proportion between partial- and full-thickness rotator cuff tear. CI: confidence interval.

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Table 1

Study characteristics

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Values are presented as mean (range) or mean±standard deviation.

MINORS: Methodological Index for Nonrandomized Studies.

Table 2

Patient characteristics

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Values are presented as mean (range) or mean±standard deviation.

M: male, F: female, NR: not reported.

*Two patients participated in two sporting activities; †Athletes involved in ≥1 sports.

Table 3

Characteristics of injuries and treatment

kjsm-37-121-i003

NR: not reported, SLAP: superior labrum anterior to posterior, SSP: supraspinatus, SAD: subacromial decompression, SSC: subscapularis, ISP: infraspinatus.

Table 4

Return to sports and outcomes

kjsm-37-121-i004

RTS: return to sport, NR: not reported, PSS: Penn shoulder score, CS: Constant score, WORCI: Western Ontario Rotator Cuff Index, ASES: American Shoulder and Elbow Surgeons, VAS: visual analog scale, SF-12: Short-form 12.

Notes

This study was supported by research grant of Korean Society of Sports Medicine for 2018.

Conflict of Interest No potential conflict of interest relevant to this article was reported.

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ORCID iDs

Du-Han Kim
https://orcid.org/0000-0002-6636-9340

Ki-Cheor Bae
https://orcid.org/0000-0002-4363-0956

Chul-Hyun Cho
https://orcid.org/0000-0003-0252-8741

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