Rotator Cuff Healing Index (RoHI)

Kwon J, Kim SH, Lee YH, Kim TI, Oh JH. The Rotator Cuff Healing Index: a new scoring system to predict rotator cuff healing after surgical repair. Am J Sports Med. 2019;47(1):173-180. doi:10.1177/0363546518810763

The Rotator Cuff Healing Index (RoHI) is a 15-point scoring system that predicts the likelihood of successful rotator cuff repair after surgery by evaluating risk factors. It assigns points based on: retraction of the tendon (4 points), infraspinatus fatty infiltration (3 points), and 2 points each for anteroposterior (AP) tear size, patient age, bone mineral density (BMD), and level of work activity. 

The RoHI score predicts the risk of repair failure:

  • Low scores (≤4 points) are ssociated with a low failure rate
  • High scores (≥10 points) are associated with a high failure rate

It is a useful tool to aid surgeons and patients in the decision-making process for rotator cuff repair surgery. In some cases where the risk of failure is high then options to improve healing or reconstruction can be considered. These include Platelet Rich Plasma, Augmentation with a patch (autograft, allograft, zenograft or synthetic), Superior Capsular Reconstruction (SCR) or a Reverse Shoulder Replacement. 

Rotator Cuff Healing Index (RoHI) — Educational Calculator

This calculator reproduces the published Rotator Cuff Healing Index (RoHI) to summarise preoperative risk factors for healing failure after rotator cuff repair. For educational use only.

Age >70 → +2 points.
>2.5 cm → +2 points.
0 / +1 / +2 / +4 points respectively.
Grade ≥2 → +3 points.
T-score ≤ −2.5 → +2 points.
High → +2 points.
Chance of Healing†
—
RoHI Score
0
0
5
7
10
15
94%
68%
38%
14%
Enter values to see the banded risk summary.
† Cohort anchors shown for orientation (not patient-specific prediction). Bands: ≤4 (low), 5–9 (intermediate), ≥10 (high).
What this calculator uses
  • Age >70 years = +2
  • AP tear size >2.5 cm = +2
  • Retraction: <1 cm = 0; 1–<2 = +1; 2–<3 = +2; ≥3 = +4
  • Infraspinatus fatty infiltration (Goutallier) ≥2 = +3
  • Bone mineral density T-score ≤−2.5 = +2
  • High work/activity level = +2

Source: Kwon J, Kim SH, Lee YH, Kim TI, Oh JH. The Rotator Cuff Healing Index. Am J Sports Med. 2019;47(1):173–180. PubMed

This tool is for educational use by clinicians and is not medical advice. It does not account for all patient- or surgery-specific variables.