Background Rotator cuff injuries are common shoulder disorders, yet predicting postoperative functional recovery remains challenging. This study aimed to investigate the predictive value of preoperative MRI quantitative parameters and serum biomarkers for functional outcomes after arthroscopic rotator cuff repair. Methods This retrospective study consecutively enrolled 305 patients who underwent primary arthroscopic rotator cuff repair from January 2022 to January 2025. Patients were divided into a good prognosis group (UCLA score ≥28, n = 198) and a poor prognosis group (UCLA score <28, n = 107) based on six-month postoperative function. Preoperative MRI parameters (supraspinatus tendon retraction distance, fat infiltration, glenoid tilt angle, tear dimensions, and joint effusion) and serum biomarkers (fibrinogen, fibrin degradation products, and C-reactive protein) were assessed. Results Compared to the good prognosis group, the poor prognosis group had significantly greater supraspinatus tendon retraction (24.61 mm vs. 18.28 mm, P < 0.001), higher rates of moderate-to-severe fat infiltration (60.75% vs. 26.77%, P < 0.001), larger glenoid tilt angle (41.22° vs. 34.54°, P < 0.001), greater tear length (3.51 cm vs. 2.47 cm, P < 0.001) and width (2.44 cm vs. 1.57 cm, P < 0.001), and elevated levels of fibrinogen (4.12 g/L vs. 3.25 g/L, P < 0.001), fibrin degradation products (4.05 μg/mL vs. 2.75 μg/mL, P < 0.001), and C-reactive protein (12.46 mg/L vs. 8.62 mg/L, P < 0.001). These factors, except joint effusion, were identified as independent predictors in multivariate analysis. The constructed nomogram showed strong discriminatory ability (AUC = 0.863). Conclusion This study identifies a set of preoperative MRI and serologic factors that are independently associated with, and can help stratify the risk for, poor functional recovery at six months postoperatively. The developed nomogram demonstrates good predictive performance for clinical use.
Xu et al. (Mon,) studied this question.