Variation among Argentinean Orthopedics Surgeons in the Indications in Rotator Cuff Lesions

Introduction: Indications in the treatment of rotator cuff lesions are widely discussed and not standardized. The aim of this study is to evaluate the variability among Argentinean orthopedic surgeons regarding the indications of treatment in different rotator cuff lesions. Methods: A questionnaire was designed based on the study carried out by Dunn et al. (JBJS Am 2005). Its aim was to gather the opinion of Argentine orthopedic surgeons on decision making concerning different rotator cuff lesions. Surgeons were divided into general orthopedic surgeons or shoulder specialists according to the number of shoulders treated surgically in the last year. The questionnaire has two sections: four hypothetical clinical cases and 11 questions about factors that could influence treatment selection. Results: Out of 556 questionnaires sent, 162 were completed, 117 by orthopedic surgeons and 45 by shoulder specialists. The specialists reported mostly arthroscopic repairs (57%), orthopedic surgeons reported repairing these lesions mainly by mini open or open technique (48% and 21% respectively). The highest agreement between both groups was evidenced in case number 1 (traumatic partial injuries in young patients (70% in favor of rotator cuff repair)). There was also agreement in the contraindication of the use of corticosteroids before surgery (p = 0.74), and in the repair of rotator cuff as a factor to prevent osteoarthritis (p = 0.27). Rotator cuff repair failure rate was considered to be 20%, not evidencing differences between groups. Conclusions: This study evidences the variation in indications between Argentinean surgeons in the treatment of rotator cuff lesions. The variability in the management of these patients, makes it difficult to establish protocols of treatment, or consensus guidelines to help standardize treatments for these injuries