Speed of recovery after rotator cuff surgery: definition and predictive model

Objectives: The speed of recovery after rotator cuff surgery is variable, poorly studied and has no precise definition. However, it is one of the questions often asked by our patients. It allows us to plan the postoperative follow-up and to determine whether sick leave is necessary. Methods: The objective of the study was to define the speed of recovery after rotator cuff surgery and to analyze the predictive factors. Prospective longitudinal follow-up of 135 rotator cuff surgery patients. Patients who missed one of the 3 scheduled appointments in the first 6 months were excluded. Patients were evaluated by Constant (CS), Quick-Dash (QD), SSV, VAS pain and VAS satisfaction scores. A regression model was used to estimate the speed of recovery (VITESS) for each patient expressed in CS points/month. Predictive factors included demographic, psychological, socio-professional, radiographic and surgical data. Results: 107 patients were included, 65 men and 42 women with a mean age of 55 years. The mean VITESS was 22 CS points/month (4.61 ± 12) which corresponds to a mean theoretical time of 2.7 months (1.15) to recover 60 CS points. Positive predictive factors were age >65 years, male gender, regular sports and a low preoperative QD score. Negative predictive factors were anxiety, sick leave (SL), a high QD score, suture involving the supraspinatus (SSP) and significant postoperative pain. The final multivariate model included SSP suture, QD, SL, and age >65 years (p <0.0001, R2 = 40). Conclusion: Recovery rate can be measured in CS points/month. This intuitive definition reflects the variability in patient recovery time. With a simple 4-parameter model, the consequences of a procedure can be estimated.