Chung and colleagues tested whether bone mineral density on DEXA predicts failure of healing after arthroscopic cuff repair, alongside the usual tear and patient factors.
Retrospective cohort of 272 arthroscopic full‑thickness repairs by one surgeon in Korea, 2004 to 2008, imaged at a mean 13 months and followed a mean 37.2 months.
Key Findings
62 of 272 repairs (22.8%) failed to heal.
Failure rose with lower bone density: 9.0% with a normal T‑score, 30.2% with osteopenia and 41.7% with osteoporosis.
On multivariate analysis only three factors stayed independent: bone density (P = .001), infraspinatus fatty infiltration (P = .014) and amount of retraction (P = .027).
Age, female sex, diabetes, tear width, supraspinatus fat, acromiohumeral distance and biceps procedures were significant alone but not after adjustment.
Healed and unhealed repairs did not differ in final pain, ASES, SST or Constant scores.
DEXA measures hip and spine, not the greater tuberosity where anchors sit, and healing was judged by two different imaging methods.
Board pearl
The osteoporosis odds ratio was unadjusted. The 7.25 for osteoporosis and 4.38 for osteopenia compare raw failure rates by category. In the adjusted model, bone density carried an odds ratio of 0.53 per unit of T‑score.
Authors' conclusion
Bone mineral density, as well as FI of the infraspinatus and amount of retraction, was an independent determining factor affecting postoperative rotator cuff healing. Further studies with prospective, randomized, and controlled design are needed to confirm the relationship between BMD and postoperative rotator cuff healing.
Chung and colleagues tested whether bone mineral density on DEXA predicts failure of healing after arthroscopic cuff repair, alongside the usual tear and patient factors.
Retrospective cohort of 272 arthroscopic full‑thickness repairs by one surgeon in Korea, 2004 to 2008, imaged at a mean 13 months and followed a mean 37.2 months.
Key Findings
62 of 272 repairs (22.8%) failed to heal.
Failure rose with lower bone density: 9.0% with a normal T‑score, 30.2% with osteopenia and 41.7% with osteoporosis.
On multivariate analysis only three factors stayed independent: bone density (P = .001), infraspinatus fatty infiltration (P = .014) and amount of retraction (P = .027).
Age, female sex, diabetes, tear width, supraspinatus fat, acromiohumeral distance and biceps procedures were significant alone but not after adjustment.
Healed and unhealed repairs did not differ in final pain, ASES, SST or Constant scores.
DEXA measures hip and spine, not the greater tuberosity where anchors sit, and healing was judged by two different imaging methods.
Board pearl
The osteoporosis odds ratio was unadjusted. The 7.25 for osteoporosis and 4.38 for osteopenia compare raw failure rates by category. In the adjusted model, bone density carried an odds ratio of 0.53 per unit of T‑score.
Authors' conclusion
Bone mineral density, as well as FI of the infraspinatus and amount of retraction, was an independent determining factor affecting postoperative rotator cuff healing. Further studies with prospective, randomized, and controlled design are needed to confirm the relationship between BMD and postoperative rotator cuff healing.