Preoperative Resilience Does Not Predict Functional Outcomes After Rotator Cuff Repair: A Systematic Review

Purpose To determine whether preoperative or concurrent resilience is related to postoperative functional outcomes after arthroscopic rotator cuff repair (aRCR). Methods A literature search was conducted from PubMed, SportDiscus, and OVID Medline databases to identify studies evaluating the effect of preoperative resilience on postoperative outcomes in aRCR patients. Articles were included if they measured preoperative or concurrent resilience in aRCR patients as well as postoperative outcomes with a minimum 6‐month follow‐up. Concurrent resilience refers to resilience measured during the postoperative recovery period rather than prior to surgery (preoperative resilience). Patient resilience as measured via any resilience scale (e.g., Brief Resilience Scale, Life Orientation Test‐Revised, and Connor‐Davidson Resilience Scale) were collected, as were functional outcome scores such as the American Shoulder and Elbow Surgeons (ASES) score. Due to heterogeneity in study designs, a qualitative analysis was performed. Results Seven studies, with a total of 614 patients, met the inclusion criteria. Six included studies that evaluated preoperative patient resilience and ASES scores found that preoperative patient resilience was not correlated with ASES scores 0.5 to 4 years following aRCR. Four studies assessed the relationship between concurrent resilience and ASES scores, with 2 studies showing significant correlations and 2 studies finding no significant correlation. Conclusions Preoperative patient resilience does not correlate with postoperative ASES scores after aRCR. Concurrent patient resilience during recovery shows mixed associations with postoperative ASES scores, with some studies reporting significant correlations and others finding none. Level of Evidence Level IV, systematic review of Level II to IV studies.