scholarly journals Effect of arthroscopic rotator cuff surgery in patients with preoperative restricted range of motion

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Helen Razmjou ◽  
Patrick Henry ◽  
Giuseppe Costa ◽  
Tim Dwyer ◽  
Richard Holtby
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Restricted Range ◽  
Arthroscopic Rotator Cuff ◽  
Rotator Cuff Surgery

scholarly journals Assessment of malpractice claims associated with rotator cuff surgery

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
David Deckey ◽  
Adam E.M. Eltorai ◽  
Joseph A. Gil ◽  
Alan H. Daniels
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Surgical Complications ◽  
Common Reason ◽  
Malpractice Litigation ◽  
Claims Database ◽  
Malpractice Claims ◽  
Pain And Suffering ◽  
Rotator Cuff Surgery ◽  
Retrospective Investigation

Rotator cuff surgery is a commonly performed and may lead to malpractice litigation. Despite this, there is a paucity of data evaluating outcomes of malpractice litigation following rotator cuff surgery. A retrospective investigation of the VerdictSearch legal claims database following rotator cuff surgery was performed. Plaintiff demographics, reason for litigation, and the effect of surgical complications were assessed as were the proportion of plaintiff rulings and size of payments. In total, 40 cases were analyzed. Mean age of plaintiffs was 52±11.2 years; 30 (75%) plaintiffs were male. Twenty-six cases (65% of suits) named pain and weakness as a complication of the procedure. In total, 60% (24) resulted in a defendant ruling, 25% (10) in a plaintiff ruling, and 15% (6) in a settlement. Total liabilities of the 40 cases were $15,365,321 with individual awards ranging from $75,000 to $5,000,000. Mean plaintiff award was $694,032±$586,835 (range: $75,000 to $1,900,000). Mean settlement amount was $1,404,167±$1,816,481 (range: $75,000 to $5,000,000). This study is the first examination of legal claims following rotator cuff surgery. Objective symptoms following surgery, such as decreased range of motion and rotator cuff weakness, as well as subjective complaints of pain and suffering were the most common reason for litigation, and when successful, led to indemnity payments averaging under $1 million each.

Early Versus Delayed Passive Range of Motion Exercise for Arthroscopic Rotator Cuff Repair

2014 ◽  
Vol 43 (5) ◽  
pp. 1265-1273 ◽  
Author(s):  
Ke-Vin Chang ◽  
Chen-Yu Hung ◽  
Der-Sheng Han ◽  
Wen-Shiang Chen ◽  
Tyng-Guey Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Motion Exercise ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Dyslipidemia With Perioperative Statin Usage Is Not Associated With Poorer 24-Month Functional Outcomes After Arthroscopic Rotator Cuff Surgery

2020 ◽  
Vol 48 (10) ◽  
pp. 2518-2524
Author(s):  
Gerald Joseph ShengXiang Zeng ◽  
Merrill Jian Hui Lee ◽  
Jerry Yongqiang Chen ◽  
Benjamin Fu Hong Ang ◽  
Ying Hao ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Density Lipoprotein ◽  
Rotator Cuff Disease ◽  
Significant Difference ◽  
Statin Usage ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Rotator Cuff Surgery

Background: Current literature suggests a higher rate of rotator cuff disease development in patients with dyslipidemia (DL). Moderate to high levels of DL are associated with higher rates of retear and revision surgery after arthroscopic rotator cuff repair. Statins protect against development of rotator cuff disease and mitigate the need for rotator cuff repair. Purpose: We aimed to investigate the influence of DL and statin use on postoperative functional outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Between 2010 and 2016, 266 patients underwent arthroscopic double-row rotator cuff repair for atraumatic full-thickness tears. Evaluation was conducted preoperatively and at 3, 6, 12, and 24 months postoperatively. Three functional outcome measures were used (Constant Shoulder Score [CSS], Oxford Shoulder Score [OXF], and University of California, Los Angeles, Shoulder Rating Scale [UCLASS]), as well as a visual analog scale (VAS) for pain. DL and non-DL were classified through screening of health and assessment of lipid levels within 6 months of surgery (triglycerides, total cholesterol, low-density lipoprotein, and high-density lipoprotein). Patients with DL were divided into statin users and nonusers. Types and dosages of statins were recorded, and intensity and equivalency charts were employed for standardization. Mann-Whitney U test and Pearson chi-square test were used for analysis. Generalized estimating equations and linear mixed models were used to examine the influence of DL and statin dosage, respectively on percentage change of postoperative outcome scores. Results: Increased age was associated with a higher incidence of DL ( P < .001), and 86% of the DL group was taking statins. The DL group also exhibited poorer scores preoperatively (CSS, P = .001; OXF, P = .032). No significant difference in scores was elicited between the DL and non-DL groups at 24 months. However, patients with DL experienced greater percentage improvement of CSS and OXF from preoperative baseline than did patients without DL ( P = .008 and P = .034, respectively) at 24 months. There was no significant difference in 24-month functional outcomes between statin users and nonusers. No statistically significant change of CSS; OXF; UCLASS; or VAS was noted with increasing statin doses at 24 months. Conclusion: Patients with DL with perioperative statin usage did not have poorer 24-month functional outcomes after arthroscopic rotator cuff surgery compared with those in patients without DL.

Establishing Maximal Medical Improvement After Arthroscopic Rotator Cuff Repair

2017 ◽  
Vol 46 (4) ◽  
pp. 1000-1007 ◽  
Author(s):  
William A. Zuke ◽  
Timothy S. Leroux ◽  
Bonnie P. Gregory ◽  
Austin Black ◽  
Brian Forsythe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcomes ◽  
Arthroscopic Rotator Cuff Repair ◽  
Orthopaedic Care ◽  
Patient Reported ◽  
Clinically Significant ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. Purpose: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care. Given that arthroscopic rotator cuff repair is a common ambulatory orthopaedic procedure, the purpose of this study was to establish a time frame for maximal medical improvement (the state when improvement has stabilized) after arthroscopic rotator cuff repair. Study Design: Systematic review. Methods: A systematic review of the literature was conducted, identifying studies reporting sequential patient-reported outcomes up to a minimum of 2 years after arthroscopic rotator cuff repair. The primary clinical outcome was patient-reported outcomes at 3-month, 6-month, 1-year, and 2-year follow-up. Secondary clinical outcomes included range of motion, strength, retears, and complications. Clinically significant improvement was determined between various time intervals by use of the minimal clinically important difference. Results: The review included 19 studies including 1370 patients who underwent rotator cuff repair. Clinically significant improvement in patient-reported outcomes was seen up to 1 year after rotator cuff repair, but no clinical significance was noted from 1 year to 2 years. The majority of improvement in strength and range of motion was seen up to 6 months, but no clinically meaningful improvement was seen thereafter. All reported complications and the majority of retears occurred within 6 months after rotator cuff repair. Conclusion: After rotator cuff repair, a clinically significant improvement in patient-reported outcomes, range of motion, and strength was seen up to 1 year after surgery, but not beyond this. This information is important not only to establish appropriate patient expectations but also to determine a time frame for outcome collection after surgery to better define value in orthopaedic care.

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