• BACKGROUND
    • An association between higher preoperative Goutallier stage and higher retear rates following primary rotator cuff repairs has been previously reported. However, there are few reviews which have described clear retear rates for each repaired tendon classified according to preoperative Goutallier stage. The purpose of this study was therefore to systematically review the literature on the relationship between preoperative Goutallier stage and retear rates and provide predictable retear rates following primary repair of posterosuperior rotator cuff tears.
  • METHODS
    • A systematic literature review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist utilizing PubMed, MEDLINE, and Cochrane Library. English-language studies of Level I through IV evidence examining the clinical results of primarily repaired posterosuperior rotator cuff tears as a function of Goutallier stage using magnetic resonance imaging were included. The primary outcome of interest was retear rates according to preoperative Goutallier stage. As a secondary outcome, rotator cuff tears were divided into 2 subgroups (Goutallier stage 0-2 and 3-4) and retear rates were assessed between the 2 subgroups. A random effects model with binomial within-study variance was used for both outcomes.
  • RESULTS
    • Nine studies (687 shoulders) satisfied all inclusion criteria and reported sufficient data for statistical analysis. In the supraspinatus muscle group, rotator cuff muscles with preoperative Goutallier stages of 0, 1, and 2 had retear rates of 19.1%, 27.8%, and 33.5%, respectively, with no significant differences between each category. In contrast, when preoperative Goutallier stage of 3 and 4 existed, significant differences compared to Goutallier 0, 1, and 2 were observed with a retear rate of 74.1% and 78.5%, respectively. In the infraspinatus muscle group, the retear rates following rotator cuff repairs were 20.0%, 32.1%, and 35.1% in Goutallier 0, 1, and 2, respectively, with no significant differences between each category. In Goutallier 3 and 4, the rate was 76.6% and 100.0%, respectively, with significant differences compared to Goutallier 0, 1, and 2.
  • CONCLUSION
    • The results of this study have clearly demonstrated that retear rates following surgical repair of the rotator cuff increased in proportion to the preoperative Goutallier stage in both the supraspinatus and infraspinatus muscles.