scholarly journals FACTORS AFFECTING RETURN TO WORK FOLLOWING ARTHROSCOPIC ROTATOR CUFF REPAIR: A CASE‐CONTROL STUDY IN AN OCCUPATIONAL MEDICINE CLINIC AND SINGLE‐SURGEON PRACTICE

2020 ◽  
Vol 50 (S1) ◽  
pp. 13-13
2021 ◽  
pp. 036354652110232
Author(s):  
Jessica M. Eager ◽  
William J. Warrender ◽  
Carly B. Deusenbery ◽  
Grant Jamgochian ◽  
Arjun Singh ◽  
...  

Background: Impaired healing after rotator cuff repair is a major concern, with retear rates as high as 94%. A method to predict whether patients are likely to experience poor surgical outcomes would change clinical practice. While various patient factors, such as age and tear size, have been linked to poor functional outcomes, it is currently very challenging to predict outcomes before surgery. Purpose: To evaluate gene expression differences in tissue collected during surgery between patients who ultimately went on to have good outcomes and those who experienced a retear, in an effort to determine if surgical outcomes can be predicted. Study Design: Case-control study; Level of evidence, 3. Methods: Rotator cuff tissue was collected at the time of surgery from 140 patients. Patients were tracked for a minimum of 6 months to identify those with good or poor outcomes, using clinical functional scores and follow-up magnetic resonance imaging to confirm failure to heal or retear. Gene expression differences between 8 patients with poor outcomes and 28 patients with good outcomes were assessed using a multiplex gene expression analysis via NanoString and a custom-curated panel of 145 genes related to various stages of rotator cuff healing. Results: Although significant differences in the expression of individual genes were not observed, gene set enrichment analysis highlighted major differences in gene sets. Patients who had poor healing outcomes showed greater expression of gene sets related to extracellular matrix production ( P < .0001) and cellular biosynthetic pathways ( P < .001), while patients who had good healing outcomes showed greater expression of genes associated with the proinflammatory (M1) macrophage phenotype ( P < .05). Conclusion: These results suggest that a more proinflammatory, fibrotic environment before repair may play a role in poor healing outcome. With validation in a larger cohort, these results may ultimately lead to diagnostic methods to preoperatively predict those at risk for poor surgical outcomes.


2021 ◽  
Author(s):  
Ijaz Khan ◽  
Manaal Fatima ◽  
Corey Scholes ◽  
Vikram Kandhari ◽  
K.M. Ponnanna ◽  
...  

Background: Return to work (RTW) following arthroscopic rotator cuff repair (aRCR) within New South Wales (NSW), Australia, under compensable schemes has not been reported. Aims: Determine factors affecting RTW status and time in patients treated with aRCR under state-based compensation schemes, compared to those outside such schemes. Methods: Patients undergoing aRCR by one surgeon with minimum 1-year follow-up were grouped into those under (CP) or outside (non-CP) workers or vehicle accident compensation schemes, matched by age and gender. RTW status and time were assessed using chi-square analysis and multivariable linear regression. Results: Of 1054 available patients, 90 CP patients were identified with 29 consented and matched to non-CP (N=29). A higher proportion of CP patients (17.2 vs 0%, P<0.001) never returned to work and a lower proportion resumed pre-injury duties at first RTW (3 vs 52%, P<0.01). Median time to first RTW did not differ between CP and non-CP groups (5.1 vs 4.4, P=0.86). Smoking (P=0.007) and post-injury activity level (P=0.004) were significantly associated with longer time to first RTW, whereas compensation status was not. Conclusions: CP patients undergoing aRCR in NSW are at risk of not returning to work. For those that return, there is no significant difference compared to non-CP in time to first RTW. Particularly, patient and management factors associated with extended time to first RTW have been identified. Interventions aimed at modifiable factors such as smoking cessation and increasing preoperative activity may improve future outcomes.


2019 ◽  
Vol 4 (0) ◽  
pp. n/a
Author(s):  
Takaki Imai ◽  
Masafumi Gotoh ◽  
Keita Hagie ◽  
Keiji Fukuda ◽  
Misa Ogino ◽  
...  

Author(s):  
Vani J. Sabesan ◽  
Rajin Shahriar ◽  
Kiran Chatha ◽  
Danielle L. Malone ◽  
Alexandria Sherwood ◽  
...  

2021 ◽  
Vol 13 (2) ◽  
pp. 21-24
Author(s):  
William S Rhode

By focusing on arthroscopic rotator cuff repair in a worker’s compensation patient population that are without personal injuries, previous ipsi-lateral shoulder injury, any concomitant pathologies or being federal employees, the rate of return-to-work (RTW) can be better isolated as an outcome of the surgery. RTW rate for a consecutive 50 patient cohort was 98% with 58% achieving full duty. A single patient with a frozen shoulder was unable to return to work at any level. These RTW rates contrast with several previous studies that reported significantly lower RTW rates for workers with compensation than workers without compensation. All but three patients improved their UCLA scores after the repair.


Sign in / Sign up

Export Citation Format

Share Document