Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis

Objectives: To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy. Data sources: PubMed, CINAHL and Scopus were searched from inception to June 2017. Study selection: Participants presented with signs and symptoms suggestive of rotator cuff tendino-pathy/tendinosis/tendinitis, shoulder impingement syndrome, or subacromial bursitis diagnosed by clinical tests and/or conventional imaging. Data extraction: Screening, quality assessment and data extraction were carried out by 2 reviewers. Data synthesis: Sixteen studies were included in this review. Overall, 22 factors were identified and 5 factors were explored using meta-analysis. Pooled analyses provided strong evidence that age above 50 years (odds ratio (OR) = 3.31, 95% confidence interval (95% CI) = 2.30-4.76, I² = 0%, p < 0.001) and diabetes (OR = 2.24, 95% CI = 1.37-3.65, I² = 0%, p = 0.001) were associated with increased risk of rotator cuff tendinopathy. In addition, moderate evidence showed that work with the shoulder above 90° was associated with increased risk of rotator cuff tendinopathy (OR = 2.41, 95% CI = 1.31-4.45, I²= 83%, p = 0.005). Conclusion: Age above 50 years, diabetes and overhead activities were associated with increased risk of rotator cuff tendinopathy.