Appendix 8: Quality of evidence according to GRADE (outcome: retear).

Prognostic factors / N shoulders / N
studies / N
cohorts / Univariate analysis / Multivariate analysis / Grade factors / Overall quality of evidence
+ / 0 / - / + / 0 / - / Phase / Limitations / Inconsistency / Indirectness / Imprecision / Publication bias / Effect size / Dose effect
ACJ procedures / 921 / 8 / 7 / 1 / 5 / 2 / 2 / 2 / X / X / V / X / V / X / X / +
Acromioplasty / 247 / 4 / 4 / 3 / 1 / 1 / X / V / V / X / V / X / X / +
ADL / 95 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / +
Age / 3403 / 30 / 29 / 18 / 10 / 4 / 6 / 2 / X / X / V / X / V / X / X / +
Aggravation of symptoms / 449 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / +
AHD / 1019 / 5 / 5 / 2 / 3 / 2 / 1 / X / X / V / X / V / X / X / +
Acromial index / 103 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / +
AROM / 424 / 4 / 4 / 2 / 1 / 2 / 1 / X / V / X / X / V / X / X / +
ASA Grade / 69 / 1 / 1 / 1 / 1 / V / X / X / X / X / X / X / +
ASES baseline / 418 / 4 / 4 / 1 / 3 / 1 / V / V / V / X / V / X / X / ++
Biceps procedures / 1072 / 10 / 9 / 4 / 3 / 2 / 6 / 2 / X / X / V / X / V / X / X / +
BMD / 380 / 2 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / +
BMI / 121 / 2 / 2 / 2 / 1 / V / V / V / X / X / X / X / +
Comorbidities / 524 / 4 / 4 / 4 / 1 / X / V / V / X / V / X / X / +
Constant baseline / 351 / 5 / 5 / 3 / 2 / 1 / V / V / V / X / V / X / X / ++
Tendon delamination / 799 / 5 / 5 / 1 / 3 / 1 / 1 / 1 / X / X / V / X / V / X / X / +
Diabetes / 475 / 3 / 3 / 1 / 2 / 1 / 1 / X / V / V / X / X / X / X / +
Dominance / 856 / 8 / 8 / 6 / 4 / 2 / X / V / V / X / V / X / X / ++
Fatty infiltration / 2237 / 18 / 18 / 13 / 4 / 7 / 1 / 2 / X / V / V / X / V / X / X / ++
Footprint coverage / 121 / 2 / 2 / 2 / 1 / X / V / X / X / X / X / X / +
Gender (female) / 1170 / 15 / 14 / 2 / 11 / 7 / 2 / X / V / V / X / V / X / X / ++
Injections / 957 / 4 / 4 / 3 / 1 / 1 / X / V / V / X / V / X / X / +
MTJ position / 84 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / +
Muscle atrophy / 100 / 2 / 2 / 1 / 1 / 1 / 1 / X / V / V / X / X / X / X / +
Narcotics / 127 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / +
NSAIDs / 233 / 2 / 2 / 2 / 1 / V / V / V / X / X / X / X / +
No. of anchors / 341 / 4 / 4 / 1 / 3 / 1 / V / V / V / X / V / X / X / ++
No. of tendons involved / 518 / 9 / 8 / 6 / 3 / 1 / 1 / X / X / V / X / V / X / X / +
Onset (traumatic) / 736 / 5 / 5 / 1 / 4 / 1 / 1 / X / V / V / X / V / X / X / +
Pain / 480 / 5 / 5 / 3 / 2 / 1 / V / V / V / X / V / X / X / ++
PROM / 380 / 2 / 2 / 2 / 1 / X / V / V / X / X / X / X / +
Pseudoparalysis / 285 / 2 / 2 / 1 / 1 / 1 / 1 / X / V / X / X / X / X / X / +
Reducibility / 500 / 1 / 1 / 1 / 1 / 1 / X / X / V / V / X / X / X / +
SLAP tears / 311 / 3 / 3 / 1 / 3 / 1 / V / V / V / X / X / X / X / +
Smoking / 978 / 8 / 8 / 6 / 3 / 1 / X / V / V / X / V / X / X / +
Sports activity level / 557 / 3 / 3 / 2 / 1 / 1 / 1 / X / V / V / X / X / X / X / +
SSV / 44 / 1 / 1 / 1 / 1 / V / X / X / X / X / X / X / +
Strength baseline / 229 / 3 / 3 / 1 / 1 / 1 / 1 / V / V / V / X / X / X / X / +
Surgical technique (anchors/combined) / 169 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / +
Surgical technique (MF) / 73 / 1 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / +
Surgical technique (O/A) / 104 / 2 / 2 / 2 / 1 / X / V / V / X / X / X / X / +
Surgical technique (SR/DR) / 1061 / 9 / 8 / 6 / 1 / 3 / 1 / 2 / X / X / V / X / V / X / X / +
Tear shape / 135 / 2 / 2 / 1 / 2 / 1 / X / V / V / X / X / X / X / +
Tear size / 3139 / 24 / 23 / 18 / 5 / 7 / 5 / 2 / X / X / V / X / V / X / X / +
Tendon length / 198 / 4 / 4 / 3 / 1 / 1 / X / X / X / X / V / X / X / +
Tendon quality / 733 / 4 / 3 / 2 / 2 / 1 / 1 / X / X / V / X / V / X / X / +
Tendon retraction / 1190 / 13 / 13 / 7 / 5 / 2 / 4 / 2 / X / X / V / X / V / X / X / +
Timing / 1801 / 13 / 13 / 2 / 9 / 5 / 2 / X / V / V / X / V / X / X / ++
Type of anchors / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / +
Type of work / 725 / 5 / 5 / 4 / 2 / 1 / X / V / V / X / V / X / X / +
WORC baseline / 90 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / +
Work comp / 641 / 2 / 2 / 1 / 1 / 1 / X / V / V / V / X / X / X / +

Abbreviations: X = serious limitations; V = no serious limitations; A= arthroscopy; O=open; ADL= activities of daily living; BMD= bone mineral density; BMI= body mass index; ASA= American Society of Anesthesiologists; Work comp=workers compensation claim; NSAIDs= non-steroidal anti-inflammatory drugs; AROM= active range of motion; PROM= passive range of motion; ASES= American Shoulder and Elbow Surgeons Standardized Shoulder assessment form; SSV= subjective shoulder value; WORC=Western Ontario Rotator Cuff; ACJ= acromioclavicular joint; AHD= acromiohumeral distance; MTJ= musculotendinous junction; SR= single row; DR= double row; MF= microfractures. Overall quality of evidence: +, very low; ++, low; +++, moderate; ++++, high.

Appendix D: Grade of evidence (outcome: ASES).

Prognostic factors / N shoulders / N
studies / N
cohorts / Univariate
analysis / Multivariate analysis / Grade factors / Overall
+ / 0 / - / + / 0 / - / Phase / Limitations / Inconsistency / Indirectness / Imprecision / Publication bias / Effect size / Dose effect
ACJ procedures / 596 / 6 / 5 / 3 / 1 / 2 / 1 / 1 / X / V / V / X / V / X / X / 1
Acromion morphology / 78 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Age / 1068 / 10 / 9 / 8 / 4 / 2 / X / V / V / X / V / X / X / 2
Aggravation of symptoms / 255 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / 1
AHD / 226 / 2 / 2 / 1 / 2 / 1 / X / V / X / X / X / X / X / 1
Acromial index / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
AROM / 285 / 2 / 2 / 2 / 1 / 1 / X / V / X / X / X / X / X / 1
ASES baseline / 259 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Biceps procedures / 815 / 8 / 7 / 5 / 5 / 2 / X / V / V / X / V / X / X / 2
BMD / 108 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
BMI / 149 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Comorbidities / 108 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Tendon delamination / 78 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Diabetes / 108 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Dominance / 441 / 4 / 4 / 4 / 2 / 1 / X / V / V / X / V / X / X / 1
Fatty Infiltration / 732 / 7 / 7 / 4 / 2 / 4 / 1 / 2 / X / X / V / X / V / X / X / 2
Footprint coverage / 85 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Gender (female) / 821 / 7 / 7 / 5 / 1 / 3 / 1 / X / V / V / X / V / X / X / 1
Muscle atrophy / 38 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Narcotics / 233 / 2 / 2 / 2 / 1 / V / V / V / X / X / X / X / 1
NSAIDs / 233 / 2 / 2 / 2 / 1 / V / V / V / X / X / X / X / 1
No. of anchors / 127 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
No. of tendons involved / 233 / 3 / 2 / 1 / 2 / 1 / V / X / V / X / X / X / X / 1
Onset (traumatic) / 318 / 2 / 2 / 1 / 2 / 1 / X / V / V / X / X / X / X / 1
Pain / 341 / 3 / 3 / 1 / 2 / 1 / V / V / V / X / X / X / X / 1
PROM / 108 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Pseudoparalysis / 285 / 2 / 2 / 2 / 1 / 1 / X / V / X / X / X / X / X / 1
SLAP tears / 311 / 3 / 3 / 1 / 2 / 1 / V / V / V / X / X / X / X / 1
Smoking / 426 / 3 / 3 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Sports activity level / 285 / 2 / 2 / 2 / 1 / 1 / X / V / X / X / X / X / X / 1
Surgical technique (O/A) / 72 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Surgical technique (SR/DR) / 608 / 6 / 5 / 4 / 3 / 1 / X / V / V / X / V / X / X / 1
Tear size / 902 / 9 / 9 / 4 / 3 / 5 / 2 / X / V / V / X / V / X / X / 2
Tendon quality / 233 / 3 / 2 / 1 / 2 / 1 / V / V / V / X / X / X / X / 1
Tendon retraction / 576 / 5 / 5 / 4 / 1 / 3 / 1 / X / V / V / X / V / X / X / 1
Timing / 582 / 5 / 5 / 3 / 1 / 4 / 2 / X / V / V / X / V / X / X / 2
Type of anchors / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Type of work / 285 / 2 / 2 / 2 / 1 / 1 / X / V / X / X / X / X / X / 1
Work comp / 141 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / V / X / 1

Appendix E: Grade of evidence (outcome: Constant).

Prognostic factors / N shoulders / N
studies / N
cohorts / Univariate analysis / Multivariate analysis / Grade factors / Overall
+ / 0 / - / + / 0 / - / Phase / Limitations / Inconsistency / Indirectness / Imprecision / Publication bias / Effect size / Dose effect
ACJ procedures / 484 / 5 / 5 / 4 / 2 / 1 / X / V / V / X / V / X / X / 1
Acromion morphology / 78 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Acromioplasty / 120 / 2 / 2 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Activity level (work and sport) / 40 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Age / 1712 / 13 / 13 / 1 / 4 / 5 / 5 / 1 / 2 / X / X / V / X / V / X / X / 1
Aggravation of symptoms / 255 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / 1
AHD / 694 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
AROM / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
ASA Grade / 138 / 2 / 2 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Biceps disorders / 145 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Biceps procedures / 609 / 7 / 7 / 6 / 2 / 1 / X / V / V / X / V / X / X / 1
BMI / 42 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Bone quality / 104 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Constant baseline / 463 / 6 / 6 / 2 / 1 / 3 / 1 / X / X / V / X / V / X / X / 1
Tendon delamination / 654 / 2 / 2 / 2 / 2 / 1 / X / X / V / V / X / X / X / 1
Dominance / 645 / 7 / 7 / 5 / 3 / 1 / X / V / V / X / V / X / X / 1
Fatty Infiltration / 1723 / 12 / 12 / 6 / 3 / 4 / 1 / 2 / X / X / V / X / V / X / X / 1
Footprint coverage / 85 / 1 / 1 / 1 / 1 / X / X / X / X / X / X / X / 1
Gender (female) / 1607 / 12 / 12 / 5 / 4 / 4 / 3 / 2 / X / X / V / X / V / X / X / 1
Injections / 648 / 2 / 2 / 2 / 1 / X / V / V / V / X / X / X / 1
Muscle atrophy / 89 / 2 / 2 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
No. of anchors / 73 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
No. of tendons involved / 131 / 2 / 2 / 1 / 1 / 1 / X / V / V / X / X / X / X / 1
Onset (traumatic) / 524 / 5 / 5 / 4 / 2 / 1 / X / V / V / X / V / X / X / 1
Pseudoparalysis / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Reducibility / 104 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
SLAP tears / 78 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Smoking / 219 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / 1
Sports activity level / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Strength baseline / 176 / 2 / 2 / 2 / 1 / X / V / V / X / X / X / X / 1
Surgical technique (O/A) / 249 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / 1
Tear shape / 145 / 2 / 2 / 1 / 1 / 1 / V / V / V / X / X / X / X / 1
Tear size / 1208 / 15 / 15 / 7 / 5 / 5 / 2 / 2 / X / X / V / X / V / X / X / 1
Tendon quality / 720 / 3 / 3 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Tendon retraction / 1215 / 8 / 8 / 6 / 1 / 1 / 1 / 1 / X / X / V / X / V / X / X / 1
Timing / 840 / 10 / 10 / 7 / 1 / 2 / 2 / 2 / X / X / V / X / V / X / X / 1
Type of anchors / 177 / 1 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Type of work / 930 / 4 / 4 / 1 / 1 / 2 / 1 / 1 / X / X / V / X / V / X / X / 1
Work comp / 793 / 4 / 4 / 3 / 1 / 1 / X / X / V / V / V / X / X / 1
Surgical technique (SR/DR) / 267 / 2 / 2 / 2 / 1 / 1 / X / V / V / X / X / X / X / 1
Surgical technique (MF) / 73 / 1 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1

Appendix F: Grade of evidence (outcome: DASH).

Prognostic factors / N shoulders / N studies / N
cohorts / Univariate analysis / Multivariate analysis / Grade factors / Overall
+ / 0 / - / + / 0 / - / Phase / Limitations / Inconsistency / Indirectness / Imprecision / Publication bias / Effect size / Dose effect
Age / 388 / 4 / 4 / 1 / 3 / 1 / 2 / X / X / V / X / V / X / X / 1
Biceps procedures / 238 / 3 / 3 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
BMI / 154 / 1 / 1 / 1 / 1 / 1 / V / X / V / V / X / X / X / 1
Comorbidities / 522 / 4 / 4 / 1 / 3 / 1 / 2 / X / X / V / X / V / X / X / 1
DASH baseline / 263 / 3 / 3 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Dominance / 145 / 2 / 2 / 1 / 1 / 1 / V / V / V / X / X / X / X / 1
Fatty Infiltration / 145 / 2 / 2 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Gender (female) / 388 / 4 / 4 / 1 / 3 / 1 / 2 / X / X / V / X / V / X / X / 1
NSAIDs / 118 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
No. of anchors / 166 / 2 / 2 / 1 / 1 / 1 / X / V / V / X / X / X / X / 1
Patient’s expectations / 125 / 1 / 1 / 1 / 1 / 1 / X / X / V / V / X / V / X / 1
Preoperative rehabilitation / 118 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Smoking / 243 / 2 / 2 / 2 / 1 / X / V / V / X / X / X / X / 1
Strength baseline / 72 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Surgical technique (MF) / 73 / 1 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Surgical technique (O/A) / 243 / 2 / 2 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Surgical technique (SR/DR) / 165 / 2 / 2 / 2 / 1 / X / V / V / X / X / X / X / 1
Tear shape / 145 / 2 / 2 / 1 / 1 / 1 / V / V / V / X / X / X / X / 1
Tear size / 388 / 4 / 4 / 1 / 1 / 3 / 1 / X / V / V / X / V / X / X / 1
Tendon retraction / 145 / 2 / 2 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Timing / 198 / 2 / 2 / 1 / 1 / 1 / X / X / V / V / X / X / X / 1
Type of work / 73 / 1 / 1 / 1 / 1 / V / X / V / X / X / X / X / 1
Work comp / 279 / 3 / 2 / 2 / 3 / 1 / X / V / V / V / X / X / X / 1
Acromial index / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
ACJ morphology / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Chondral damage / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Coracoid impingement / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Labral lesions / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
Subscapularis tears / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1
No. of tendons involved / 93 / 1 / 1 / 1 / 1 / X / X / V / X / X / X / X / 1

Abbreviations: ACJ= acromio-humeral joint; AHD= acromio-humeral distance; ADL= activities of daily living; AROM= active range of motion; ASA=American Society of Anesthesiologists; BMD=bone mineral density; BMI = body mass index; O= open; A= arthroscopy; SR= single row; DR= double row; MF= microfractures.