Predictors of pain and functional outcomes after operative treatment for rotator cuff tears

Nitin B. Jain, Gregory D. Ayers, Run Fan, John E. Kuhn, Keith M. Baumgarten, Elizabeth Matzkin, Laurence D. Higgins

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background: Optimal patient selection is key to success of operative treatment for cuff tears. We assessed predictors of pain and functional outcomes in a longitudinal cohort of patients undergoing operative treatment. Methods: From March 2011 to January 2015, a cohort of patients with rotator cuff tears undergoing rotator cuff surgery was recruited. Patients completed a detailed health and demographic questionnaire, standardized shoulder questionnaires, including the Shoulder Pain and Disability Index (SPADI), and underwent a magnetic resonance imaging scan. Patients received follow-up questionnaires at 3, 6, 12, and 18 months. We assessed longitudinal predictors of SPADI using longitudinal mixed models. Interactions with follow-up duration after surgery were also assessed. Results: In our analysis (n = 50), a lower Fear-Avoidance Beliefs Questionnaire physical activity score (P =.001) predicted a lower SPADI score (better shoulder pain and function). Those consuming alcohol 1 to 2 times per week or more had lower SPADI scores than those consuming alcohol 2 to 3 times per month or less (P =.017). Both of these variables had a significant interaction with duration of follow-up. Variables that were not significant predictors of SPADI included sociodemographic characteristics, magnetic resonance imaging characteristics, such as tear size and muscle quality, shoulder strength, and variations in surgical techniques/performance of adjuvant surgical procedures. Conclusions: Those with higher fear avoidance behavior and alcohol use of 1 to 2 times per week had worse shoulder pain and function at 18 months of follow-up. These data can be used to select optimal candidates for operative treatment of rotator cuff tears and assist with patient education and expectations before treatment.

Original languageEnglish (US)
Pages (from-to)1393-1400
Number of pages8
JournalJournal of Shoulder and Elbow Surgery
Issue number8
StatePublished - Aug 2018
Externally publishedYes


  • Level II
  • Prospective Cohort Design
  • Rotator cuff
  • Treatment Study
  • cohort
  • outcomes
  • predictors
  • shoulder pain
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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