Perioperative complications and outcomes in patients with paraplegia undergoing rotator cuff repair

2021 ◽  
pp. 175857322110364
Author(s):  
Marissa L Boettcher ◽  
Kirsi S Oldenburg ◽  
Garrett Neel ◽  
Bryce Kunkle ◽  
Josef K Eichinger ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Length Of Stay ◽  
Shoulder Pain ◽  
Rotator Cuff Repair ◽  
Perioperative Complications ◽  
Large Sample Size ◽  
Complication Rates ◽  
Perioperative Complication ◽  
Tract Infections ◽  
Cuff Repair

Background Patients with paraplegia often experience chronic shoulder pain due to overuse. We sought to determine if these patients have an increased prevalence of perioperative complications and higher rates of re-admissions and rotator cuff re-tears relative to able-bodied controls following rotator cuff repair (RCR). Methods We queried the NRD (2011–2018) to identify all patients undergoing primary RCR (n = 34,451) and identified cohorts of matched paraplegic and non-paraplegic patients (n = 194 each). We compared demographic factors, comorbidity profiles, perioperative complication rates, length of stay, revision rates, and re-admission rates between the two groups. Results Patients with paraplegia had lower rates of chronic obstructive pulmonary disease (p = 0.02), hypertension (p = 0.007), congestive heart failure (p = 0.027), obesity (p < 0.001), and prior myocardial infarction (p = 0.01). Additionally, patients with paraplegia experienced higher rates of urinary tract infections (11.9% vs. 2.1%, p < 0.001), lower rates of acute respiratory distress syndrome (0% vs. 3.1%, p = 0.041), and had a longer length of stay (4-days vs. 1-day, p < 0.001). Revision rates were similar for the two groups. Conclusions Compared to matched controls, patients with paraplegia were found to have similar demographic characteristics, less comorbidities, similar perioperative complication rates, and similar revision rates. These findings address a gap in the literature regarding surgical management of shoulder pain in patients with paraplegia by providing a matched comparison with a large sample size.

scholarly journals Patch-Augmented Rotator Cuff Repair and Superior Capsule Reconstruction

2016 ◽  
Vol 10 (1) ◽  
pp. 315-323 ◽  
Author(s):  
M. Petri ◽  
J.A. Greenspoon ◽  
S.G. Moulton ◽  
P.J. Millett
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Rotator Cuff Repair ◽  
Treatment Options ◽  
Rotator Cuff Tears ◽  
Long Term Results ◽  
Complication Rates ◽  
Younger Patients ◽  
Superior Capsule Reconstruction ◽  
Cuff Repair

Background: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. Methods: A selective literature search was performed and personal surgical experiences are reported. Results: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients. Therefore, patch-augmented rotator cuff repair or superior capsule reconstruction (SCR) have been recently developed as arthroscopically applicable treatment options, with promising biomechanical and early clinical results. Conclusion: For younger patients with irreparable rotator cuff tears wishing to avoid tendon transfers or reverse total shoulder arthroplasty, both patch-augmentation and SCR represent treatment options that may delay the need for more invasive surgery.

scholarly journals Immediate costs of mini-open versus arthroscopic rotator cuff repair in an Asian population

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668449 ◽  
Author(s):  
Yik Jing Hui ◽  
Alex Quok An Teo ◽  
Siddharth Sharma ◽  
Bryan Hsi Ming Tan ◽  
V Prem Kumar
Keyword(s):  
Rotator Cuff ◽  
Length Of Stay ◽  
Rotator Cuff Repair ◽  
Open Repair ◽  
Asian Population ◽  
Arthroscopic Repair ◽  
Arthroscopic Rotator Cuff ◽  
The Cost ◽  
Cuff Repair ◽  
Mini Open

Objective: While there has been increasing interest in minimally invasive surgery, the expenses incurred by patients undergoing this form of surgery have not been comprehensively studied. The authors compared the costs borne by patients undergoing arthroscopic rotator cuff repair with the standard mini-open repair at a tertiary hospital in an Asian population. Patients and Methods: This was a retrospective cohort study. The authors studied the inpatient hospital bills of patients following rotator cuff tear repair between January 2010 and October 2014 via the hospital electronic medical records system. 148 patients had arthroscopic repair and 78 had mini-open repair. The cost of implants, consumables, and the total cost of hospitalization were analyzed. Operative times and length of stay for both procedures were also studied. Constant scores and American Shoulder Elbow Scores (ASES) were recorded preoperatively and at 1 year postoperatively. Results: Three fellowship-trained surgeons performed arthroscopic repairs and one performed the mini-open repair. The cost of implants and consumables was significantly higher with arthroscopic repair. The duration of surgery was also significantly longer with that technique. There was no difference in length of stay between the two techniques. There was also no difference in Constant scores or ASES scores, both preoperatively and at 1 year postoperatively. Conclusions: The immediate costs of mini-open repair of rotator cuff tears are significantly less than that of arthroscopic repair. Most of the difference arises from the cost of implants and consumables. Equivalent functional outcomes from both techniques suggest that mini-open repair may be more cost-effective.

Impact of patient resilience on early recovery from rotator cuff repair

2021 ◽  
pp. 175857322110035
Author(s):  
Charlie D Wilson ◽  
Benjamin D Welling ◽  
Kendall AP Hammonds ◽  
Brett N Robin
Keyword(s):  
Mental Health ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rotator Cuff Repair ◽  
Outcome Measurement ◽  
Physical And Mental Health ◽  
Early Recovery ◽  
Patient Reported ◽  
And Function ◽  
Cuff Repair

Aims We sought to evaluate early recovery from rotator cuff repair by assessing the correlation between patient resilience and postoperative shoulder pain and function, and physical and mental health. Methods Patients scheduled to undergo arthroscopic rotator cuff repair were prospectively enrolled. Resilience was assessed using the Brief Resilience Scale (BRS), pain and function was measured by American Society of Shoulder and Elbow Surgeons (ASES) shoulder scores, and physical and mental health was measured by the Patient-Reported Outcome Measurement Information System Global Health-10 (PROMIS-10). All scores were obtained preoperatively and postoperatively at three- and six months. Spearman correlation coefficient (r) was used to assess the relationship between variables. Results Ninety-eight patients ultimately underwent rotator cuff repair; 76 and 68 patients provided three- and six-month follow-up, respectively. There was no statistically significant correlation between preoperative BRS and three- and six-month ASES. However, there was a statistically significant correlation between preoperative BRS and three-month PROMIS-10 (r = 0.3763, p = 0.009) and concurrent BRS and PROMIS-10 at three months (r = 0.5657, p = 0.0025) and six months (r = 0.5308, p = 0.0025). Discussion Resilience appears to be more predictive of global physical and mental health than shoulder pain and function in early recovery from rotator cuff repair.

Influence of provider volume on length of stay, operating room time, and discharge status for rotator cuff repair

2005 ◽  
Vol 14 (4) ◽  
pp. 407-413 ◽  
Author(s):  
Nitin B. Jain ◽  
Ricardo Pietrobon ◽  
Ulrich Guller ◽  
Ajit S. Ahluwalia ◽  
Laurence D. Higgins
Keyword(s):  
Rotator Cuff ◽  
Length Of Stay ◽  
Operating Room ◽  
Rotator Cuff Repair ◽  
Provider Volume ◽  
Discharge Status ◽  
Cuff Repair ◽  
Room Time ◽  
Operating Room Time

The Relationship of Staged, Bilateral Arthroscopic Primary Rotator Cuff Repair Timing and Postoperative Complications

2021 ◽  
pp. 036354652110151
Author(s):  
Jourdan M. Cancienne ◽  
Patrick J. Denard ◽  
Grant E. Garrigues ◽  
Brian C. Werner
Keyword(s):  
Emergency Department ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Emergency Department Visits ◽  
Single Stage ◽  
Medical Complications ◽  
Control Group ◽  
Complication Rates ◽  
The Relationship ◽  
Cuff Repair

Background: Although previous studies have reported acceptable clinical outcomes after simultaneous, single-stage bilateral and staged bilateral rotator cuff repair (RCR), few studies have been adequately powered to compare postoperative complication rates at various time intervals between procedures. Purpose: To examine the relationship between the timing of bilateral arthroscopic RCR and complications. Study Design: Descriptive epidemiology study. Methods: Patients from the Medicare data set within the PearlDiver database who underwent bilateral RCR between 2005 and 2014 were identified. These patients were then stratified by time between surgeries into cohorts: (1) single stage, (2) <3 months, (3) 3 to 6 months, (4) 6 to 9 months, (5) 9 months to 1 year, and (6) 1 to 2 years. Surgical and medical complications of these cohorts were compared with those of a control cohort of patients who underwent bilateral RCR >2 years apart using a regression analysis. Results: A total of 11,079 patients who underwent bilateral RCR were identified. Patients who underwent single-stage bilateral arthroscopic RCR experienced higher rates of revision RCR (odds ratio [OR], 2.1; P < .0001), reverse total shoulder arthroplasty (RTSA) (OR, 2.47; P < .0001), and postoperative infection (OR, 2.18; P = .007) in addition to higher rates of venous thromboembolism (VTE) (OR, 1.78; P = .031) and emergency department visits (OR, 1.51; P = .002) compared with the control group. Patients who underwent bilateral RCR with a <3-month interval had higher rates of revision surgery (OR, 1.56; P = .003), RTSA (OR, 1.89; P = .002), and lysis of adhesions (OR, 2.31; P < .0001) in addition to increased rates of VTE (OR, 1.92; P = .015) and emergency department visits (OR, 1.62; P < .0001) compared with the control group. There were no differences in any surgical or medical complications when surgeries were staged by ≥3 months compared with controls. Conclusion: Patients with Medicare undergoing single-stage and staged bilateral RCR who had the second repair within 3 months had significantly higher rates of multiple medical and surgical complications compared with patients waiting >2 years between procedures.

scholarly journals Diabetic patients are almost twice as likely to experience complications from arthroscopic rotator cuff repair

2019 ◽  
Vol 12 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Z Borton ◽  
F Shivji ◽  
S Simeen ◽  
R Williams ◽  
A Tambe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Large Population ◽  
Frozen Shoulder ◽  
Arthroscopic Rotator Cuff Repair ◽  
Diabetic Patients ◽  
Consecutive Series ◽  
Complication Rates ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

AimsLarge population-based studies have demonstrated increased prevalence of rotator cuff disease amongst diabetics. Recent studies have suggested comparable clinical outcomes from rotator cuff repair despite suggestions of increased complication rates amongst diabetics. However, there is a relative paucity of studies considering the effect of diabetes upon complication rate. We aim to report and quantify the effect of diabetes on complication rates following arthroscopic rotator cuff repair.Materials and methodsA retrospective review of a consecutive series of patients undergoing arthroscopic rotator cuff repair between January 2011 and December 2014 was performed. Diabetic status and complication data defined as infection, frozen shoulder, re-tear or re-operation were collected and interrogated.ResultsA total of 462 patients were included at median follow-up of 5.6 years. Diabetics were significantly more likely to experience frozen shoulder (15.8% vs. 4.4%, p = 0.001), re-tear (26.3% vs. 15.6%, p = 0.042) or at least one complication following surgery (35.1% vs. 22.7%, p = 0.041) compared to non-diabetics. These equated to odds ratios of 4.03, 1.94 and 1.84, respectively.ConclusionsDiabetic patients are almost twice as likely to experience complications following arthroscopic rotator cuff repair, including double the risk of repair failure and more than four times the risk of frozen shoulder.

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