Risk factors influencing postoperative outcome of arthroscopic rotator cuff repair and construction of a nomogram prediction model.

OBJECTIVE

To investigate the risk factors influencing the postoperative outcome of arthroscopic rotator cuff repair (ARCR) and develop a nomogram prediction model.

METHODS

A retrospective study was conducted on 302 patients who underwent ARCR from January 2019 to August 2023. Patients were categorized into two groups: a control group with 150 patients showing good recovery and an observation group with 152 patients exhibiting poor recovery. Relevant clinical data were collected and statistically analyzed. A nomogram model was constructed based on the results of multivariate logistic regression analysis. The model's accuracy, discrimination, and clinical utility were evaluated using calibration charts, AUC, c-index, and decision curve analysis. Internal validation was performed through self-random sampling.

RESULTS

Univariate and multivariate regression analysis identified having a frozen shoulder, large rotator cuff tear, increased intraoperative rivet use, diabetes, and traumatic tear as predictive risk factors for poor postoperative outcomes. These factors were utilized to develop a clinical predictive nomogram. The nomogram model demonstrated excellent predictive accuracy for poor postoperative outcomes, both internally and externally. The unadjusted concordance index (C-index) was 0.793 [95% confidence interval (CI), 0.825-0.995]. The AUC for the nomogram was 0.788. Decision curve analysis revealed that the predictive model was clinically useful when the threshold probability ranged from 20 to 60%.

CONCLUSION

The presence of a frozen shoulder, large rotator cuff tear, increased intraoperative rivet use, diabetes, and traumatic tear elevate the risk of suboptimal outcomes following ARCR. Conversely, having a higher preoperative University of California at Los Angeles Shoulder Rating Scale score mitigates this risk. This study introduces a novel nomogram model, exhibiting relatively high accuracy, which enables clinicians to precisely assess the postoperative adverse risk among patients with rotator cuff injuries requiring arthroscopic repair at the outset of treatment.