JSES - 2026-08-13 - Journal Article; Review
Spin in Systematic Reviews on Patch-Augmented Rotator Cuff Repair: Prevalence, Predictors, and Methodological Implications.
Al-Badaineh M, Josan H, Imran B, Ebeid I, Mekhail J, Abdou M, Dagher D, Ahmed AF, Hantouly A, Khan M
Topics
Key Takeaway
Spin was present in 81.3% of systematic review abstracts on patch-augmented rotator cuff repair, with each AMSTAR-2 methodological flaw associated with 61% more spin types (IRR 1.61; 95% CI 1.08–2.49).
Summary Depth
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Summary
This study assessed the prevalence and predictors of abstract spin in systematic reviews comparing patch-augmented versus non-augmented rotator cuff repair, using Yavchitz et al.'s nine severe spin types and AMSTAR-2 for methodological quality. Spin was identified in 13 of 16 abstracts (81.3%), with spin types 5 (focus on statistically non-significant results as trending), 3 (selective reporting of favorable outcomes), and 8 (overstated conclusions) most common. Funding status, journal impact factor, and overall quality did not predict spin presence, but each AMSTAR-2 flaw independently increased spin burden by 61%.
Key Limitation
With only 16 included reviews, the univariate predictor analysis is underpowered and cannot reliably exclude funding or impact factor as spin predictors.
Original Abstract
BACKGROUND
Rotator cuff tears are a major cause of shoulder pain and dysfunction, and surgical repair is often complicated by the risk of retear, especially in patients with large, massive, revision tears and high-risk patients. Biologic or synthetic patch augmentation has emerged to reinforce repair and potentially reduce retears. Despite many systematic reviews and meta-analyses on patch-augmented versus non-augmented repair, concerns remain regarding study heterogeneity, outcome variability, and spin in interpretation and reporting, particularly in abstracts. This study assessed the methodological quality and abstract spin.
METHODS
This systematic review was conducted in accordance with the Cochrane Handbook and PRISMA guidelines. On October 30, 2025, PubMed, Scopus, and Web of Science were searched for English-language systematic reviews and meta-analyses comparing patch- or graft-augmented versus non-augmented rotator cuff repair in clinical studies. Eligible reviews reported at least one clinical, patient-reported, or imaging-based outcome. Two reviewers independently performed duplicate study selection, data extraction, spin assessment, and methodological quality appraisal using Yavchitz et al.'s nine severe spin types and AMSTAR-2.
RESULTS
Sixteen reviews and meta-analyses were included in this study. Spin was identified in 81.3% (n = 13) of the abstracts. The types were 5 (62.5%), 3 (56.2%), and 8 (50.0%). Univariate analysis found no significant associations with the funding status (p = 0.36), quality (p = 1.00), or impact factor (p = 0.95). Each AMSTAR-2 flaw was associated with 61% more spin types (IRR 1.61; 95% CI 1.08-2.49; p = 0.02).
CONCLUSION
Spin is prevalent in the abstracts of systematic reviews on patch augmentation for rotator cuff repair, regardless of funding or journal impact factor. Although spin was widespread, poor methodological quality was linked to a greater spin burden rather than its presence. These findings highlight the importance of critically appraising systematic reviews, as spin may contribute to an overly favorable interpretation of the evidence and potentially influence clinical decision-making. Readers should interpret the conclusions cautiously and verify the claims against the full-text results.
LEVEL OF EVIDENCE
Research Methodology Study, Systematic Review.