Low resilience is associated with decreased patient-reported outcomes following arthroscopic rotator cuff repair

The purpose of this study was to evaluate the relationship between preoperative resiliency and outcomes following arthroscopic rotator cuff repair (ARCR). The hypothesis was that patients with low preoperative resilience would have poorer postoperative patient-reported outcomes compared to patients with high preoperative resilience following ARCR. Eighty-one consecutive patients undergoing ARCR over a 1-year period at a single institution were prospectively evaluated. Baseline evaluation included a Brief Resilience Scale (BRS), range of motion, and the following patient-reported outcomes (PROs): visual analog scale for pain (VAS), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Veterans RAND 12-Item Health Survey (VR-12), and the Single Assessment Numeric Evaluation (SANE) tests. PROs and range of motion were reassessed at a minimum of 2 years postoperatively. Patients were divided based on the baseline BRS score into low resilience (LR), normal resilience (NR), and high resilience (HR), and outcome scores were calculated for each group. Additionally, a regression analysis was performed to evaluate predictors of the final ASES score as a continuous variable. Despite similar baseline characteristics and postoperative range of motion and VAS scores, patients with LR had poorer postoperative ASES scores compared with patients with HR. The postoperative ASES score was 69 in the LR group, compared with 90 in the HR group ( P  = .031). Satisfaction was 78% in the LR group, compared with 100% in the HR group ( P  = .086). Based on regression analysis, the final ASES score increased 1.6 points for every 1-point increase in resilience. Preoperative low resilience is associated with an >20-point drop in postoperative ASES scores following ARCR. This difference is present despite similar baseline characteristics, suggesting that the psychological contribution to postoperative outcomes is substantial.