Background: The outcome after rotator cuff surgery has been reported
frequently with use of condition-specific measures, but patient satisfaction
has not been well studied. The purpose of this study was to identify the
determinants of patient satisfaction with the outcome after rotator cuff
Methods: A cohort of 311 patients undergoing rotator cuff surgery
was studied prospectively. Two hundred and fifty-four patients had subjective
follow-up for a minimum of one year, and fifty-seven patients had subjective
and objective follow-up for a minimum of one year. Diagnoses included
tendinitis or impingement (eighty patients), a partial-thickness rotator cuff
tear (fifty-five patients), and a full-thickness rotator cuff tear (176
patients). The dependent variable was patient satisfaction with the outcome,
graded ordinally on a scale of 1 to 10. Independent variables included
demographic, surgical, objective follow-up, and subjective follow-up
parameters. Univariate and multivariate analyses were performed to identify
the determinants of satisfaction.
Results: Univariate analysis of demographic variables demonstrated
no significant differences (p > 0.05) with respect to patient satisfaction.
Analysis of the surgical variables showed significantly decreased satisfaction
(p < 0.05) for patients who had débridement for a massive,
irreparable cuff tear; those who had subscapularis tears; and those with
larger supraspinatus and infraspinatus tears. Analysis of the objective
variables at follow-up demonstrated significantly decreased satisfaction (p
< 0.05) for patients with diminished and weakened forward elevation,
impingement signs, and acromioclavicular joint pain and tenderness. Univariate
analysis of subjective variables at follow-up showed significantly decreased
satisfaction (p < 0.001) for patients with pain, functional difficulty, and
Multivariate analysis demonstrated significantly decreased satisfaction
associated with pain (p < 0.001) and dysfunction (p < 0.05). A
significant relationship (p < 0.05) was detected between satisfaction and a
willingness to recommend the surgery to another. A significant relationship (p
< 0.05) was also found between satisfaction and the American Shoulder and
Elbow Surgeons score.
Conclusions: Subjective variables of symptoms and function have the
most robust associations with patient satisfaction following rotator cuff
surgery. Thus, in assessing the outcome of rotator cuff surgery from the
perspective of patient satisfaction with outcome, we emphasize the importance
of patient-derived subjective assessment of symptoms and function.
Level of Evidence: Prognostic Level II. See Instructions
to Authors for a complete description of levels of evidence.