Return to sport after arthroscopic rotator cuff repair: epidemiology and prognostic factors in a Swiss multicentre cohort

Objectives To investigate patients’ sports activities prior to and after arthroscopic rotator cuff repair (ARCR) and to better understand the relationship between patient, injury and sport-specific factors and return to sport (RTS) after ARCR. Methods As a part of the ARCR_Pred multicentre cohort study, patients from 19 centres undergoing primary ARCR for partial or complete rotator cuff tears between June 2020 and November 2021 were prospectively enrolled. Only patients who participated in sports prior to the injury were included. Injury characteristics, sports activity, sociodemographic, psychological and rehabilitation-specific factors, including the ability to return to any sport, were recorded preoperatively and postoperatively at 6 weeks, 6, 12 and 24 months. Prognostic factors for full RTS were identified using univariable and multivariable logistic regression analysis. Results Of the 725 eligible patients, 37.2% were female, and the mean age was 57.7 years. Among all eligible patients, 57.4% achieved full RTS at 24 months, and 43.8% returned to their primary preinjury sport. Delayed initiation of passive mobilisation (risk ratio (RR) 0.94 (95% CI 0.89 to 0.99), p=0.017) was associated with incomplete RTS in univariable analysis. In multivariable analysis, favourable prognostic factors of full RTS included traumatic injury aetiology (RR 1.21 (95% CI 1.07 to 1.37), p=0.002), high motivation to RTS at baseline (RR 1.18 (95% CI 1.05 to 1.33), p=0.005), higher sports activity levels at 6 months (RR 1.04 (95% CI 1.01 to 1.07), p=0.002) and a low depression score at 12 months (RR 0.97 (95% CI 0.95 to 0.98), p<0.001). Conclusion Over half of ARCR patients reach full RTS within 24 months, with traumatic injuries, high motivation and higher sports activity at baseline having a more favourable prognosis. Our findings inform individualised postoperative rehabilitation and counselling regarding RTS following ARCR.