Retrospective Cohort Study
Copyright ©The Author(s) 2022.
World J Orthop. Jul 18, 2022; 13(7): 631-643
Published online Jul 18, 2022. doi: 10.5312/wjo.v13.i7.631
Table 1 Demographic information


With GHOA
Without GHOA


Tear size group
Tear size group
Overall (n = 142)Case overall (n = 71)Small (0-1 cm) (n = 21)Medium (1-3 cm) (n = 28)Large (3-5 cm) (n = 22)Control overall (n = 71)Small (0-1 cm) (n = 28)Medium (1-3 cm) (n = 30)Large (3-5 cm) (n = 13)
Age (in yr) at surgery, median (IQR)64 (60, 70)64 (60, 70)63 (62, 67)63 (58, 67.5)66 (62, 71)64 (60, 70)63 (59.5, 68.5)65 (61, 70)63 (61, 69)
BMI, median (IQR)29.2 (25.8, 32.9)29.8 (26.7, 33.2)32.9 (29.4, 35.9)28.1 (24.5, 30.8)29 (27.3, 33.2)28.5 (25.5, 31)29.9 (27, 31)27.2 (24.5, 30.4)27.5 (24.7, 32.1)
Time (in yr) since DOS, median (IQR)8.1 (6.9, 9.3)8.2 (6.9, 9.3)8 (7.1, 9.4)8 (6.4, 9.3)8.3 (7.1, 8.9)8.1 (6.8, 9.3)8.3 (6.8, 9.6)8 (7.5, 8.8)7.8 (6.9, 9.3)
Tear size, median (IQR)2 (1, 3)2 (1, 3.5)1 (1, 1)2 (1.7, 2.6)4 (3.5, 4)1.5 (1, 2.5).5 (.5, 1)2 (1.5, 2.5)4 (3.7, 4.3)
Male82 (57.7)41 (57.7)10 (47.6)13 (46.4)18 (81.8)41 (57.7)13 (46.4)19 (63.3)9 (69.2)
Sex, n (%)
Female60 (42.3)30 (42.3)11 (52.4)15 (53.6)4 (18.2)30 (42.3)15 (53.6)11 (36.7)4 (30.8)
Smoking, n (%)
Never84 (59.2)41 (57.7)16 (76.2)14 (50.0)11 (50.0)43 (60.6)19 (67.9)19 (63.3)5 (38.5)
Previous53 (37.3)29 (40.8)5 (23.8)13 (46.4)11 (50.0)24 (33.8)7 (25.0)10 (33.3)7 (53.8)
Current5 (3.5)1 (1.4)0 (0)1 (3.6)0 (0)4 (5.6)2 (7.1)1 (3.3)1 (7.7)
Diabetes, n (%)
No115 (81.0)57 (80.3)18 (85.7)24 (85.7)15 (68.2)58 (81.7)22 (78.6)27 (90.0)9 (69.2)
Yes27 (19.0)14 (19.7)3 (14.3)4 (14.3)7 (31.8)13 (18.3)6 (21.4)3 (10.0)4 (30.8)
Preoperative samilson-prieto score, n (%)
None71 (50.0)1 (1.4)0 (0)1 (3.6)0 (0)70 (98.6)28 (100.0)29 (96.7)13 (100.0)
Mild (< 3 mm)62 (43.7)61 (85.9)18 (85.7)27 (96.4)16 (72.7)1 (1.4)0 (0)1 (3.3)0 (0)
Moderate (3 mm-7 mm)9 (6.3)9 (12.7)3 (14.3)0 (0)6 (27.3)0 (0)0 (0)0 (0)0 (0)
Goutallier classification, n (%)
Grade 0 (normal muscle)95 (66.9)47 (66.2)18 (85.7)19 (67.9)10 (45.5)48 (67.6)23 (82.1)20 (66.7)5 (38.5)
Grade 1 (some fattystreaks)36 (25.4)18 (25.4)2 (9.5)7 (25.0)9 (40.9)18 (25.4)5 (17.9)8 (26.7)5 (38.5)
Grade 2 (< 50% fattymuscle atrophy)11 (7.7)6 (8.5)1 (4.8)2 (7.1)3 (13.6)5 (7.0)0 (0)2 (6.7)3 (23.1)
Muscle atrophy (warner grading system), n (%)0 (0)
None107 (75.4)50 (70.4)18 (85.7)21 (75.0)11 (50.0)57 (80.3)24 (85.7)24 (80.0)9 (69.2)
Mild29 (20.4)17 (23.9)2 (9.5)5 (17.9)10 (45.5)12 (16.9)4 (14.3)5 (16.7)3 (23.1)
Moderate6 (4.2)4 (5.6)1 (4.8)2 (7.1)1 (4.5)2 (2.8)0 (0)1 (3.3)1 (7.7)
Primary GHOA, n (%)
No71 (50.0)0 (0)0 (0)0 (0)0 (0)71 (100.0)28 (100.0)30 (100.0)13 (100.0)
Yes71 (50.0)71 (100.0)21 (100.0)28 (100.0)22 (100.0)0 (0)0 (0)0 (0)0 (0)
Table 2 Operative data and type of operation


With GHOA
Without GHOA


Tear size group
Tear size group
Overall (n = 142)Overall Case (n = 71)Small (0-1 cm) (n = 21)Medium (1-3 cm) (n = 28)Large (3-5 cm) (n = 22)Overall Control (n = 71)Small (0-1 cm) (n = 28)Medium (1-3 cm) (n = 30)Large (3-5 cm) (n = 13)
Single row, n (%)
No124 (87.3)60 (84.5)16 (76.2)24 (85.7)20 (90.9)64 (90.1)26 (92.9)26 (86.7)12 (92.3)
Yes18 (12.7)11 (15.5)5 (23.8)4 (14.3)2 (9.1)7 (9.9)2 (7.1)4 (13.3)1 (7.7)
Double row, n (%)
Yes122 (85.9)60 (84.5)17 (81.0)23 (82.1)20 (90.9)62 (87.3)24 (85.7)26 (86.7)12 (92.3)
No20 (14.1)11 (15.5)4 (19.0)5 (17.9)2 (9.1)9 (12.7)4 (14.3)4 (13.3)1 (7.7)
Medial row, n (%)
Yes138 (97.2)69 (97.2)19 (90.5)28 (100.0)22 (100.0)69 (97.2)28 (100.0)28 (93.3)13 (100.0)
No4 (2.8)2 (2.8)2 (9.5)0 (0)0 (0)2 (2.8)0 (0)2 (6.7)0 (0)
Lateral row, n (%)
Yes120 (84.5)61 (85.9)18 (85.7)23 (82.1)20 (90.9)59 (83.1)24 (85.7)24 (80.0)11 (84.6)
No22 (15.5)10 (14.1)3 (14.3)5 (17.9)2 (9.1)12 (16.9)4 (14.3)6 (20.0)2 (15.4)
Arthrotunneler, n (%)
No139 (97.9)71 (100.0)21 (100.0)28 (100.0)22 (100.0)71 (100.0)28 (100.0)28 (93.3)12 (92.3)
Yes3 (2.1)0 (0)0 (0)0 (0)0 (0)2 (6.7)1 (7.7)
Medial row fixation type, n (%)
Missing for 6 patients
Suture tied135 (95.1)67 (94.4)19 (90.5)26 (92.9)22 (100.0)68 (95.8)28 (100.0)28 (93.3)12 (92.3)
Knotless1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
Medial row anchor type, n (%)
Missing for 11 patients
PEEK86 (60.6)53 (74.6)16 (76.2)21 (75.0)16 (72.7)33 (46.5)16 (57.1)12 (40.0)5 (38.5)
Knotted35 (24.6)10 (14.1)2 (9.5)5 (17.9)3 (13.6)25 (35.2)10 (35.7)11 (36.7)4 (30.8)
Knotless7 (4.9)0 (0)0 (0)0 (0)0 (0)7 (9.9)1 (3.6)5 (16.7)1 (7.7)
Plastic3 (2.1)3 (4.2)1 (4.8)0 (0)2 (9.1)0 (0)0 (0)0 (0)0 (0)
Lateral row fixation type, n (%)
Missing for 23 patients
Knotless90 (63.4)46 (64.8)13 (61.9)16 (57.1)17 (77.3)44 (62.0)20 (71.4)18 (60.0)6 (46.2)
Suture tied29 (20.4)15 (21.1)5 (23.8)7 (25.0)3 (13.6)14 (19.7)4 (14.3)6 (20.0)4 (30.8)
Lateral row anchor type, n (%)
Missing for 29 patients
PEEK70 (49.3)28 (39.4)12 (57.1)8 (28.6)8 (36.4)42 (59.2)21 (75.0)15 (50.0)6 (46.2)
Plastic20 (14.1)20 (28.2)3 (14.3)8 (28.6)9 (40.9)0 (0)0 (0)0 (0)0 (0)
Knotted17 (12.0)6 (8.5)1 (4.8)4 (14.3)1 (4.5)11 (15.5)3 (10.7)4 (13.3)4 (30.8)
Knotless6 (4.2)3 (4.2)1 (4.8)1 (3.6)1 (4.5)3 (4.2)0 (0)3 (10.0)0 (0)
Concurrent procedures
Distal clavicle excision, n (%)
Yes79 (55.6)41 (57.7)15 (71.4)16 (57.1)10 (45.5)38 (53.5)16 (57.1)17 (56.7)5 (38.5)
No63 (44.4)30 (42.3)6 (28.6)12 (42.9)12 (54.5)33 (46.5)12 (42.9)13 (43.3)8 (61.5)
Subacromial decompression, n (%)
Yes142 (100.0)71 (100.0)21 (100.0)28 (100.0)22 (100.0)71 (100.0)28 (100.0)30 (100.0)13 (100.0)
Capsular release, n (%)
No133 (93.7)66 (93.0)20 (95.2)25 (89.3)21 (95.5)67 (94.4)26 (92.9)30 (100.0)11 (84.6)
Yes9 (6.3)5 (7.0)1 (4.8)3 (10.7)1 (4.5)4 (5.6)2 (7.1)0 (0)2 (15.4)
Labral debridement, n (%)
No125 (88.0)63 (88.7)20 (95.2)24 (85.7)19 (86.4)62 (87.3)24 (85.7)26 (86.7)12 (92.3)
Yes17 (12.0)8 (11.3)1 (4.8)4 (14.3)3 (13.6)9 (12.7)4 (14.3)4 (13.3)1 (7.7)
Chondroplasty, n (%)
No120 (84.5)54 (76.1)14 (66.7)20 (71.4)20 (90.9)66 (93.0)25 (89.3)28 (93.3)13 (100.0)
Yes22 (15.5)17 (23.9)7 (33.3)8 (28.6)2 (9.1)5 (7.0)3 (10.7)2 (6.7)0 (0)
Biceps tenotomy, n (%)
No92 (64.8)44 (62.0)11 (52.4)20 (71.4)13 (59.1)48 (67.6)18 (64.3)23 (76.7)7 (53.8)
Yes50 (35.2)27 (38.0)10 (47.6)8 (28.6)9 (40.9)23 (32.4)10 (35.7)7 (23.3)6 (46.2)
Biceps tenodesis, n (%)
No99 (69.7)54 (76.1)20 (95.2)19 (67.9)15 (68.2)45 (63.4)18 (64.3)17 (56.7)10 (76.9)
Yes43 (30.3)17 (23.9)1 (4.8)9 (32.1)7 (31.8)26 (36.6)10 (35.7)13 (43.3)3 (23.1)
If biceps tenodesis, n (%)
Suprapectoral37 (26.1)11 (15.5)0 (0)5 (17.9)6 (27.3)26 (36.6)10 (35.7)13 (43.3)3 (23.1)
Subpectoral6 (4.2)6 (8.5)1 (4.8)4 (14.3)1 (4.5)0 (0)0 (0)0 (0)0 (0)
Table 3 Postoperative complications


With GHOA
Without GHOA


Tear size group
Tear size group
Overall (n = 142)Case Overall (n = 71)Small (0-1cm) (n = 21)Medium (1-3cm) (n = 28)Large (3-5cm) (n = 22)Control Overall (n = 71)Small (0-1cm) (n = 28)Medium (1-3cm) (n = 30)Large (3-5cm) (n = 13)
Reoperation post RCR, n (%)
No125 (88.0)60 (84.5)19 (90.5)23 (82.1)18 (81.8)65 (91.5)26 (92.9)28 (93.3)11 (84.6)
Yes17 (12.0)11 (15.5)2 (9.5)5 (17.9)4 (18.2)6 (8.5)2 (7.1)2 (6.7)2 (15.4)
Complications, n (%)
Missing for 1 patient
No111 (78.2)53 (74.6)16 (76.2)22 (78.6)15 (68.2)58 (81.7)22 (78.6)24 (80.0)12 (92.3)
Yes30 (21.1)17 (23.9)4 (19.0)6 (21.4)7 (31.8)13 (18.3)6 (21.4)6 (20.0)1 (7.7)
Wound issues, n (%)
Missing for 131 patients
No11 (7.7)9 (12.7)2 (9.5)3 (10.7)4 (18.2)2 (2.8)0 (0)2 (6.7)0 (0)
Infection, n (%)
Missing for 131 patients
No11 (7.7)9 (12.7)2 (9.5)3 (10.7)4 (18.2)2 (2.8)0 (0)2 (6.7)0 (0)
Stiffness, n (%)
Missing for 126 patients
Yes8 (5.6)5 (7.0)3 (14.3)1 (3.6)1 (4.5)3 (4.2)1 (3.6)2 (6.7)0 (0)
No8 (5.6)7 (9.9)0 (0)3 (10.7)4 (18.2)1 (1.4)0 (0)1 (3.3)0 (0)
Rotator cuff retear, n (%)
Missing for 122 patients
Yes17 (12.0)9 (12.7)0 (0)4 (14.3)5 (22.7)8 (11.3)3 (10.7)4 (13.3)1 (7.7)
No3 (2.1)2 (2.8)2 (9.5)0 (0)0 (0)1 (1.4)0 (0)1 (3.3)0 (0)
Other complication, n (%)
Missing for 128 patients
No8 (5.6)4 (5.6)1 (4.8)2 (7.1)1 (4.5)4 (5.6)1 (3.6)2 (6.7)1 (7.7)
Yes6 (4.2)3 (4.2)1 (4.8)1 (3.6)1 (4.5)3 (4.2)2 (7.1)1 (3.3)0 (0)
Other complication description, n (%)
Pain1 (0.7)1 (1.4)1 (4.8)0 (0)0 (0)0 (0)0 (0)0 (0)0 (0)
Block related neuropraxia1 (0.7)1 (1.4)0 (0)1 (3.6)0 (0)0 (0)0 (0)0 (0)0 (0)
Weakness1 (0.7)1 (1.4)0 (0)0 (0)1 (4.5)0 (0)0 (0)0 (0)0 (0)
Median nerve neuropathy1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)1 (3.6)0 (0)0 (0)
Greater tuberosity fx1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)1 (3.6)0 (0)0 (0)
Heterotopic ossification1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)0 (0)1 (3.3)0 (0)
1st reoperation diagnosis, n (%)
Other13 (9.2)9 (12.7)2 (9.5)4 (14.3)3 (13.6)4 (5.6)1 (3.6)1 (3.3)2 (15.4)
Stiffness3 (2.1)2 (2.8)0 (0)1 (3.6)1 (4.5)1 (1.4)0 (0)1 (3.3)0 (0)
Hardware pain1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)1 (3.6)0 (0)0 (0)
1st reoperation other diagnosis, n (%)
Rotator cuff arthropathy4 (2.8)3 (4.2)0 (0)2 (7.1)1 (4.5)1 (1.4)0 (0)0 (0)1 (7.7)
Rotator cuff retear4 (2.8)3 (4.2)0 (0)2 (7.1)1 (4.5)1 (1.4)0 (0)1 (3.3)0 (0)
Inflammatory arthritis1 (0.7)1 (1.4)1 (4.8)0 (0)0 (0)0 (0)0 (0)0 (0)0 (0)
Glenohumeral arthritis1 (0.7)1 (1.4)1 (4.8)0 (0)0 (0)0 (0)0 (0)0 (0)0 (0)
Retear RTC, rotator cuffarthropathy1 (0.7)1 (1.4)0 (0)0 (0)1 (4.5)0 (0)0 (0)0 (0)0 (0)
Greater tuberosity fracture1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)1 (3.6)0 (0)0 (0)
Rotator cuff arthropathy1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
1st reoperation procedure, n (%)
Conversion to RTSA8 (5.6)5 (7.0)1 (4.8)2 (7.1)2 (9.1)3 (4.2)1 (3.6)0 (0)2 (15.4)
Other6 (4.2)3 (4.2)0 (0)2 (7.1)1 (4.5)3 (4.2)1 (3.6)2 (6.7)0 (0)
Lysis of adhesions2 (1.4)2 (2.8)0 (0)1 (3.6)1 (4.5)0 (0)0 (0)0 (0)0 (0)
Conversion to TSA1 (0.7)1 (1.4)1 (4.8)0 (0)0 (0)0 (0)0 (0)0 (0)0 (0)
1st reoperation other procedure, n (%)
Revision rotator cuff repair4 (2.8)3 (4.2)0 (0)2 (7.1)1 (4.5)1 (1.4)0 (0)1 (3.3)0 (0)
Removal of heterotopicossification1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)0 (0)1 (3.3)0 (0)
Removal of hardware, RTC debridement1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)1 (3.6)0 (0)0 (0)
2nd reoperation post RCR, n (%)
Missing for 1 patient
No14 (9.9)10 (14.1)1 (4.8)5 (17.9)4 (18.2)4 (5.6)1 (3.6)2 (6.7)1 (7.7)
Yes2 (1.4)1 (1.4)1 (4.8)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
2nd reoperation diagnosis, n (%)
Other2 (1.4)1 (1.4)1 (4.8)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
2nd reoperation other diagnosis, n (%)
Insufficiency due to subscapularis failure1 (0.7)1 (1.4)1 (4.8)0 (0)0 (0)0 (0)0 (0)0 (0)0 (0)
Instability1 (0.7)0 (0)0 (0)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
2nd reoperation procedure, n (%)
Other2 (1.4)1 (1.4)1 (4.8)0 (0)0 (0)1 (1.4)0 (0)0 (0)1 (7.7)
Conversion to TSA/RTSA within 2 yr post index DOS, n (%)
No139 (97.9)69 (97.2)20 (95.2)28 (100.0)21 (95.5)70 (98.6)28 (100.0)30 (100.0)12 (92.3)
Yes3 (2.1)2 (2.8)1 (4.8)0 (0)1 (4.5)1 (1.4)0 (0)0 (0)1 (7.7)
Table 4 Patient-reported outcomes

Overall (n= 142)
With GHOA, Small tear (0-1 cm) (n= 21)
Without GHOA, Small tear (0-1 cm) (n= 28)
P value
With GHOA, Medium tear (1-3 cm) (n= 28)
Without GHOA, Medium tear (1-3 cm) (n= 30)
P value
With GHOA, Large tear (3-5 cm) (n= 22)
Without GHOA, Large tear (3-5 cm) (n= 13)
P value
MCS, median (IQR)57.1 (46.5, 61.6)60.9 (37.6, 64.1)56.3 (44.4, 61.5)> 0.9959.3 (44.6, 61.3)58.3 (50, 62.8)> 0.9954.4 (48, 57.9)51 (47.3, 60.2)> 0.99
PCS, median (IQR)49.1 (40, 52.6)40.2 (29.6, 49.1)51.4 (42.4, 55)0.14850 (44.9, 51.8)46.4 (35.1, 50.8)> 0.9952.7 (49.7, 55.4)41.8 (34.4, 53.3)> 0.99
VAS pain, median (IQR)0.0 (0.0, 0.0)0.0 (0.0, 0.0)0.0 (0.0, 0.0)> 0.990.0 (0.0, 1.0)0.0 (0.0, 1.0)> 0.990.0 (0.0, 0.0)0.0 (0.0, 0.0)> 0.99
VAS instability, median (IQR)0.0 (0.0, 0.0)0.0 (0.0, 0.0)0.0 (0.0, 0.0)> 0.990.0 (0.0, 0.0)0.0 (0.0, 0.0)-0.0 (0.0, 0.0)0.0 (0.0, 0.0)-
ASES shoulder right, median (IQR)98.3 (93.3, 100)100 (95, 100)99.2 (95, 100)> 0.9998.3 (91.7, 100)95 (91.7, 100)> 0.9998.3 (93.3, 98.3)100 (95, 100)> 0.99
ASES shoulder left, median (IQR)98.3 (90, 100)100 (85, 100)98.3 (91.7, 100)> 0.99100 (93.3, 100)95.8 (87.5, 100)> 0.99100 (91.7, 100)90 (66.7, 100)> 0.99
SANE, median (IQR)95 (85, 100)96.5 (90, 100)100 (92.5, 100)> 0.99100 (95, 100)95 (80, 100)> 0.9990 (85, 95)85 (50, 100)> 0.99