Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities

Nasuhi Altay; Fatih Emre Topsakal; Ekrem Özdemir; Esra Demirel

doi:10.32322/jhsm.1861072

Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities

Abstract

Aims: The aim of this study was to identify the comorbidities that most strongly influence re-rupture following arthroscopic rotator cuff repair (RCR) and to determine the independent risk contributions of age, diabetes mellitus, bone mineral density (BMD), tear size, and retraction. Methods: A total of 481 patients who underwent primary arthroscopic full-thickness RCR between February 2020 and June 2024 were retrospectively reviewed; after exclusions, 392 patients were included. Demographic variables, comorbidities (diabetes mellitus, smoking, obesity, hypercholesterolemia), BMD, tear size, retraction, and fatty infiltration were collected from preoperative records. Functional outcomes were assessed with Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) and Constant scores. Re-rupture was confirmed by postoperative magnetic resonance imaging (MRI) and clinical functional loss. Risk factors were analyzed using univariate and multivariate logistic regression. Results: The re-rupture rate was 18.6% (73/392). Patients with re-rupture had significantly larger tears (38.9±9.2 mm, p<0.001), greater retraction (24.8±7.5 mm, p<0.001), and lower BMD (T-score -2.1±1.8, p<0.001). In multivariate analysis, DEXA <-2 [adjusted OR (aOR) 22.51, p<0.001], diabetes mellitus (aOR 10.52, p<0.001), age >65 years (aOR 5.67, p<0.001), and large/massive tears (aOR 11.84, p<0.001) were identified as independent predictors of re-rupture. The model demonstrated excellent discrimination with an area under the curve (AUC) of 0.927. Postoperative ASES (64.5), constant (62.8), and VAS (4.8) scores were significantly worse in the re-rupture group. Conclusion: Re-rupture after arthroscopic RCR is significantly associated with older age, diabetes mellitus, low bone mineral density, and large/massive tears. Among these, DEXA <-2 and diabetes mellitus emerge as the strongest determinants of structural healing. Detailed preoperative risk profiling may enable optimization of surgical planning and personalized rehabilitation strategies for high-risk patients.

Keywords

References

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Details

Primary Language

English

Subjects

Orthopaedics

Journal Section

Research Article

Authors

Nasuhi Altay ^*
0000-0002-5518-3938
Türkiye

Fatih Emre Topsakal
0000-0002-6033-0795
Türkiye

Ekrem Özdemir
0000-0002-3709-558X
Türkiye

Esra Demirel
0000-0002-8468-6286
Türkiye

Publication Date

May 19, 2026

Submission Date

January 11, 2026

Acceptance Date

April 11, 2026

Published in Issue

Year 2026 Volume: 9 Number: 3

DOI

https://doi.org/10.32322/jhsm.1861072

IZ

https://izlik.org/JA77TG54HW

Cite

RIS / Bibtex

APA

Altay, N., Topsakal, F. E., Özdemir, E., & Demirel, E. (2026). Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities. Journal of Health Sciences and Medicine, 9(3), 608-614. https://doi.org/10.32322/jhsm.1861072

AMA

1.Altay N, Topsakal FE, Özdemir E, Demirel E. Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities. J Health Sci Med / JHSM. 2026;9(3):608-614. doi:10.32322/jhsm.1861072

Chicago

Altay, Nasuhi, Fatih Emre Topsakal, Ekrem Özdemir, and Esra Demirel. 2026. “Predictors of Re-Rupture After Arthroscopic Rotator Cuff Repair: The Role of Age and Systemic Comorbidities”. Journal of Health Sciences and Medicine 9 (3): 608-14. https://doi.org/10.32322/jhsm.1861072.

EndNote

Altay N, Topsakal FE, Özdemir E, Demirel E (May 1, 2026) Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities. Journal of Health Sciences and Medicine 9 3 608–614.

IEEE

[1]N. Altay, F. E. Topsakal, E. Özdemir, and E. Demirel, “Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities”, J Health Sci Med / JHSM, vol. 9, no. 3, pp. 608–614, May 2026, doi: 10.32322/jhsm.1861072.

ISNAD

Altay, Nasuhi - Topsakal, Fatih Emre - Özdemir, Ekrem - Demirel, Esra. “Predictors of Re-Rupture After Arthroscopic Rotator Cuff Repair: The Role of Age and Systemic Comorbidities”. Journal of Health Sciences and Medicine 9/3 (May 1, 2026): 608-614. https://doi.org/10.32322/jhsm.1861072.

JAMA

1.Altay N, Topsakal FE, Özdemir E, Demirel E. Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities. J Health Sci Med / JHSM. 2026;9:608–614.

MLA

Altay, Nasuhi, et al. “Predictors of Re-Rupture After Arthroscopic Rotator Cuff Repair: The Role of Age and Systemic Comorbidities”. Journal of Health Sciences and Medicine, vol. 9, no. 3, May 2026, pp. 608-14, doi:10.32322/jhsm.1861072.

Vancouver

1.Nasuhi Altay, Fatih Emre Topsakal, Ekrem Özdemir, Esra Demirel. Predictors of re-rupture after arthroscopic rotator cuff repair: the role of age and systemic comorbidities. J Health Sci Med / JHSM. 2026 May 1;9(3):608-14. doi:10.32322/jhsm.1861072