Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?
Fatty Infiltration and Atrophy of the Rotator Cuff do not Improve after Rotator Cuff Repair and Correlate with Poor Functional Outcome
Background The role of degenerative changes in rotator cuff musculature with respect to the functional outcomes of rotator cuff repair have only recently been recognized and are still not well understood . In addition , the reversibility of these changes with repair of the tendons is question able . Hypothesis Poorer preoperative muscle quality negatively affects outcome , and a successful outcome ( in terms of a healed repair ) might demonstrate improvements in fatty infiltration and muscle atrophy . Study Design Cohort study ; Level of evidence , 2 . Methods Thirty-eight patients ( mean age , 62 years ) were prospect ively evaluated with preoperative and 1-year postoperative clinical examination and appropriate magnetic resonance image sequencing to determine grade s of muscle atrophy and fatty infiltration of the supraspinatus and infraspinatus muscles . American Shoulder and Elbow Society ( ASES ) , Constant , and pain scores were determined as well as strength measurements . The retear rate and progression of muscle degeneration were also evaluated . Independent predictors of outcome measurements and cuff integrity were determined . Results The overall clinical outcome , including ASES , Constant , and pain scores , improved significantly ( P < .0001 ) . Strength in forward elevation improved significantly ( P < .006 ) , while external rotation strength did not . There was a strongly negative correlation between muscle quality and outcome results in most cases . When the results were adjusted for multivariate effect , muscle atrophy and fatty infiltration of the infraspinatus muscle were the only independent predictors of ASES and Constant scores ( P < .03 ) . Tear size and rotator cuff healing did not play an independent role . Tear size , however , was the only independent predictor of ultimate cuff integrity ( P = .002 ) . Both atrophy and fatty infiltration progressed significantly over the course of the study . In cases in which the tendon had re-torn , the progression was found to be more significant than when the repair proved successful ( P < .003 ) . Conclusion Muscle atrophy and fatty infiltration of the rotator cuff muscles , particularly of the infraspinatus , play a significant role in determining functional outcome after cuff repair . Tear size appears to have the most influential effect on repair integrity . A successful repair did not lead to improvement or reversal of muscle degeneration and a failed repair result ed in significantly more progression . In general , healed repairs demonstrated minimal progression . These findings suggest that repairs should be performed , if possible , before more significant deterioration in the cuff musculature in order to optimize outcomes , and that underst and ing the degree of muscle atrophy and fatty infiltration before surgery can help guide patient expectations
Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?