Perioperative Bisphosphonate Therapy Reduces the Rate of Retear After Rotator Cuff Repair: A Systematic Review and Meta-Analysis.

This study evaluated the effect of bisphosphonate therapy on tendon healing and clinical outcomes after arthroscopic rotator cuff repair in patients with osteoporosis. PubMed, Scopus, and Ovid MEDLINE were searched from inception to January 2026 to identify comparative studies of osteoporotic patients treated with bisphosphonates versus no bisphosphonate therapy. Five studies met the inclusion criteria. Bisphosphonate therapy was associated with a significantly lower rate of structural tendon retear (odds ratio, 0.32; 95% confidence interval, 0.18-0.59; P =0.0002). No significant differences were observed between groups in postoperative American Shoulder and Elbow Surgeons scores, Constant scores, or reoperation rates. Patients receiving bisphosphonates demonstrated a modest but statistically significant improvement in postoperative forward flexion (mean difference, 8.28°; 95% confidence interval, 3.54-13.02). No serious bisphosphonate-related adverse events were reported.