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 tendinopathy/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)?=?2.304.76, I2?=?0%, p<0.001) and diabetes (OR?=?2.24, 95% CI?=?1.373.65, 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?=?1.314.45, I2=?83%, p?=?0.005). CONCLUSION: Age above 50 years, diabetes and overhead activities were associated with increased risk of rotator cuff tendinopathy.