scholarly journals Tear size, general health status and smoking influence functional outcome at 5 years following arthroscopic rotator cuff repair

2021 ◽  
pp. 175857322110416
Author(s):  
Olivia Lawson ◽  
Jaimie A Nicholson ◽  
Nicholas D Clement ◽  
Will Rudge ◽  
Deborah J MacDonald ◽  
...  

Introduction There is limited medium-term outcome data regarding the predictors of functional outcome and patient satisfaction after arthroscopic rotator cuff repair. Methods 287 patients that underwent arthroscopic rotator cuff repair under a high-volume single surgeon were contacted at a minimum of 4 years following surgery. Patient demographics, tear size and co-morbidities were pre-operatively recorded. The Oxford shoulder score, EuroQol 5-dimensional score and patient satisfaction were recorded at final follow-up. Results 234 (81.5%) patients completed follow-up at a mean of 5.5 (4–9) years. There were 126 males and 108 females with a mean age of 60 (range 25–83) years. The majority of patients ( n = 211, 90%) were satisfied with their final outcome. Multivariate linear regression analysis ( R2 = 0.64) identified that increasing tear size ( p = 0.04), worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.049) were associated with a worse Oxford shoulder score. Logistic regression analysis ( R2 = 0.13) identified that worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.01) were associated with an increased risk of patient dissatisfaction. Conclusion General health status and smoking are independent predictors of functional outcome and patient satisfaction at medium-term follow-up following arthroscopic rotator cuff repair.

2021 ◽  
Vol 24 (3) ◽  
pp. 166-171
Author(s):  
Joong-Won Ha ◽  
Hyunkyo Kim ◽  
Seong Hun Kim

Background: Many patients fail to reap the benefits of rehabilitation after arthroscopic rotator cuff repair (ARCR) due to severe stiffness and pain. Thus, this study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after ARCR.Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography.Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.


2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985951
Author(s):  
Matthew J. Herring ◽  
Melissa White ◽  
Jonathan P. Braman

Background: Rotator cuff tears are common injuries that are reliably treated with arthroscopic repair, producing good to excellent results. The Western Ontario Rotator Cuff (WORC) index is a validated disease-specific instrument used to assess patient outcomes; however, no study to date has correlated WORC index with treatment failure. Purpose: To evaluate the WORC index as a predictor for successful treatment in arthroscopic rotator cuff repair. An additional purpose was to identify patient and tear characteristics associated with risk of treatment failure. Study Design: Case-control study; Level of evidence, 3. Methods: This study reviewed a total of 500 patients who underwent arthroscopic rotator cuff repair with a minimum of 2-year follow-up. Patient charts were reviewed for treatment failures, defined as persistent or recurrent shoulder pain or weakness, leading to further workup and identification of a failure to heal or recurrent tear by magnetic resonance imaging. Patient demographic and comorbidity data were gathered and correlated with risk of failure. All patients completed WORC questionnaires, and scores were correlated with risk of treatment failure. Results: There were 28 (5.6%) treatment failures at a median 28 weeks (SD, 42 weeks) postoperatively. Patients claiming workers’ compensation were 3.21 times more likely (odds ratio; P = .018) to fail treatment. Posterior interval tears (those including infraspinatus) were 3.14 times more likely ( P = .01) to fail than anterior interval tears. Tear size was associated with treatment failure; the odds of failure was 3.24 for a 2-tendon tear and 5.83 for a 3-tendon tear ( P = .03). Tears involving the nondominant arm were associated with an increased risk of failure by a factor of 3.04 (95% CI, 1.01-9.11; P = .047). A WORC score ≥80 was associated with a 95% probability of treatment success at 1 year. Conclusion: After arthroscopic rotator cuff repair, patients with WORC scores ≥80 at 1 year have a 95% probability of successful treatment and likely do not benefit from continued follow-up visits. Furthermore, several risk factors were identified that may influence outcomes after rotator cuff repair, including workers’ compensation, location of tear, tear size, and hand dominance.


2007 ◽  
Vol 16 (5) ◽  
pp. 579-585 ◽  
Author(s):  
Brian J. Cole ◽  
L. Pearce McCarty ◽  
Richard W. Kang ◽  
Winslow Alford ◽  
Paul B. Lewis ◽  
...  

2011 ◽  
Vol 20 (4) ◽  
pp. 518-528 ◽  
Author(s):  
Pietro Randelli ◽  
Paolo Arrigoni ◽  
Vincenza Ragone ◽  
Alberto Aliprandi ◽  
Paolo Cabitza

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