The AAOS 2019 Clinical Practice Guidelines for the Management of Rotator Cuff Injuries Are Unbiased and Incorporate a Diverse Body of Literature

PURPOSE: To analyze the scientific research that formed the basis of the 2019 American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines for the management of rotator cuff injuries. METHODS: All studies cited in the 2019 AAOS clinical practice guidelines for the management of rotator cuff injuries were extracted and categorized. Extracted data included type of study, number of patients, level of evidence, journal of publication, impact factor, year of publication, country of origin, contributing authors, affiliated institutions, and significant findings. Data were analyzed to determine time from publication to implementation, level of evidence, and frequency of cited journals and authors. RESULTS: The studies cited in the guideline included 15,130 patients from 140 studies published between 1994 and 2018. The overall mean time from article publication to 2019 AAOS clinical practice guidelines was 4.76 ± 2.23 years. Of articles published in 2010 to 2019, 64 studies were cited in the strong recommendation strength subcategory, and 57 articles were cited in the moderate recommendation strength subcategory. Articles published in Journal of Shoulder & Elbow Surgery and Arthroscopy were cited most frequently. The most frequent authors were J. H. Oh, R. Z. Tashjian, S. H. Kim, N. Maffulli, and J. C. Yoo. CONCLUSIONS: The 2019 AAOS CPG reference a diverse number of journals and authors, appearing to be impartial. Furthermore, prompt time from publication to implementation in the Guidelines indicates that it is possible to influence clinical guidelines with recent work. CLINICAL RELEVANCE: An analysis of the scientific research that forms the basis of the AAOS Clinical Practice Guidelines for the Management of Rotator Cuff Injuries can provide valuable information about the quality of the Guidelines.