Non-surgical influencing factors of rotator cuff retear after arthroscopic rotator cuff repair
- VernacularTitle:关节镜下肩袖撕裂修补后再撕裂的非手术性影响因素
- Author:
Zishuai HUANG
1
;
Jian WANG
1
Author Information
- Publication Type:Journal Article
- Keywords: rotator cuff injury; rotator cuff retear; non-surgical factor; acromial morphology; rotator cuff tear type; postoperative rehabilitation; engineered tissue construction
- From: Chinese Journal of Tissue Engineering Research 2025;29(27):5914-5923
- CountryChina
- Language:Chinese
- Abstract: BACKGROUND:Currently,arthroscopic rotator cuff repair has become the main method for treating rotator cuff tears.The recurrence of rotator cuff tears after arthroscopic rotator cuff repair is the result of multiple factors,and the occurrence of recurrent tears is a current research hotspot.Currently,comprehensive reviews of non-surgical factors that contribute to recurrent tears after arthroscopic rotator cuff repair are less common.OBJECTIVE:To explore the non-surgical risk factors that lead to the rotator cuff tear again after arthroscopic rotator cuff repair,provide theoretical guidance for clinical intervention,and reduce the occurrence of postoperative rotator cuff tear again.METHODS:The first author searched PubMed,Web of Science,and China National Knowledge Infrastructure in May 2023 and supplemented the literature from May 2023 to July 2024 for observational studies on non-surgical risk factors for rotator cuff retear after arthroscopic repair.The search used a combination of subject terms and free words.The literature search period was 2000-01-01/2024-07-01.RESULTS AND CONCLUSION:(1)A total of 70 articles were included for review according to the inclusion and exclusion criteria.(2)We analyzed the influence of non-surgical factors such as demographic and social risk factors,anatomical factors,rotator cuff quality,postoperative rehabilitation,type of rotator cuff tear,and timing of surgery on rotator cuff retear.(3)Aging was associated with degenerative changes in the rotator cuff,increasing the possibility of re-tearing.Metabolic diseases such as diabetes and hyperlipidemia could indirectly affect the quality and stability of repair by affecting local blood supply and tissue quality.(4)Critical shoulder angle and joint glenoid inclination were considered to be a key anatomical parameter that affects the risk of re-tearing.Patients with a critical shoulder angle＞35° had a significantly increased risk of re-tearing.A larger glenoid inclination would change the biomechanical environment of the shoulder and increase the risk of tearing.(5)The quality of the rotator cuff tendon,such as fatty infiltration and muscle retraction,and the type of tear(such as large or complex tear shape)also affected the re-tear rate.(6)Postoperative rehabilitation also had a significant impact on re-tear,including the time and method of recovery.Moderate activity helped improve blood circulation and tendon healing,but premature or excessive activity might increase the risk of tearing.Customized personalized rehabilitation programs played an important role in preventing rotator cuff re-tearing.(7)Although surgical technique is crucial to the success of rotator cuff repair,these non-surgical factors also affect postoperative outcomes and risk of retearing,and should be fully considered in clinical practice.
