Quality of life after arthroscopic rotator cuff repair: evaluation using SF-36 and an analysis of affecting clinical factors

Abstract

Background: Despite its importance, few studies regarding health-related quality of life (HRQOL) after rotator cuff repair have been reported.

Purpose: To evaluate the outcomes of rotator cuff repair in terms of HRQOL using SF-36 and to analyze factors affecting postoperative HRQOL.

Study design: Case series; Level of evidence, 4.

Methods: We included 309 patients who were followed-up for a mean 26.3 months (range, 12-48 months) after arthroscopic rotator cuff repair, between November 2004 and August 2008, and who underwent periodic measurement of HRQOL using SF-36 preoperatively, 1 year postoperatively, and at the final follow-up. The correlation between SF-36 and shoulder-specific functional outcome measures (American Shoulder and Elbow Surgeons [ASES], Simple Shoulder Test [SST], and Constant score) was evaluated using correlation analysis, and the relationship between various clinical factors, including rotator cuff healing and HRQOL, was assessed using univariate and multivariate analyses.

Results: The SF-36 scores for physical HRQOL and mental HRQOL showed significant improvement, from 40.40 to 47.53 and from 44.45 to 50.55 at 12 months after surgery, respectively (all P < .001), and improvement was maintained with 48.24 and 50.45, respectively, at the final follow-up (all P < .001). Scores also showed improvement according to all clinical variables, even after stratification of each variable. The correlation between SF-36 and shoulder-specific functional outcome measures was fair to moderate (Pearson correlation coefficients, 0.199-0.528). Various factors had significant effects on preoperative physical and mental HRQOL; however, postoperatively (at 12 months and final follow-up, respectively), only older age (P = .008 and .013), female sex (P = .036 and .043), presence of diabetes (P = .026 and .027), and low level of sports activity (P = .049 at final follow-up) had a negative effect on postoperative physical HRQOL in multivariate analysis, and female sex (P = .010 and .001) was the only factor leading to worse postoperative mental HRQOL.

Conclusion: Arthroscopic rotator cuff repair significantly improved the patients' HRQOL both physically and mentally. Older age, female sex, diabetes, and low level of sports activity were related to low postoperative physical HRQOL, and female sex was also related to low postoperative mental HRQOL.