Influence of Psychological Resilience on Postoperative Outcomes Following Rotator Cuff Repair.

Background: Resilience is emerging as a significant factor in orthopedic outcomes, including rotator cuff repair (RCR). However, its influence on postoperative recovery, particularly in different cultural and socioeconomic contexts, remains underexplored.

Methods: This retrospective cohort study included 105 patients who underwent arthroscopic RCR and completed the Brief Resilience Scale (BRS). Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score at 24 months, with secondary evaluations of University of California at Los Angels (UCLA) and Single Assessment Numeric Evaluation (SANE) scores at multiple time points. Resilience levels were categorized as low, normal, or high. Multivariate analysis was performed to identify independent predictors of outcomes, including tear characteristics and resilience.

Results: Patients with high resilience achieved significantly higher ASES scores (91.1 ± 10.6) compared to those with low resilience (58.7 ± 28.8, p = 0.002). Similarly, normal resilience was associated with better outcomes (72.8 ± 26.6, p = 0.043). BRS demonstrated an independent association with outcomes, with each one-point increase in resilience corresponding to a 1.38-point improvement in ASES scores (p = 0.014). Tear characteristics did not independently affect outcomes. Preoperative ASES score emerged as an additional independent predictor (p < 0.001). Socioeconomic context, as inferred by healthcare type, and type of surgery also appear to be relevant factors. Improvements in clinical scores were observed over time across the cohort, but no significant differences were noted between 12-month and 24-month evaluations.

Conclusions: At 24 months postoperatively, resilience significantly influenced clinical outcomes after arthroscopic RCR, with higher BRS scores associated with better ASES outcomes. Patients with low resilience demonstrated worse functional recovery compared to those with normal and high resilience.