Rotator cuff disease: opinion regarding surgical criteria and likely outcome

Thorpe, Alison; Hurworth, Mark; O’Sullivan, Peter; Mitchell, Tim; Smith, Anne

doi:10.1111/ans.13862

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…There is no consensus about the best treatment strategy for rotator cuff disorders [21, 22]. While some authors recommend conservative treatment, others advocate for surgical repair of the torn cuff [8].…”

Section: Discussionmentioning

confidence: 99%

Do we really allow patient decision-making in rotator cuff surgery? A prospective randomized study

Torrens¹,

Miquel²,

Santana³

2019

J Orthop Surg Res

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Background There is a growing patient interest in being involved in the decision-making process. However, little information is provided on how this information should be structured. Does it make a difference, in patient treatment decision-making, whether information is given based on the benefits or on the side effects in rotator cuff disorders? Methods It is a prospective randomized study that includes patients diagnosed with rotator cuff tears. Patients were randomly allocated to either group A (benefit-inform) or group B (side effect-inform) and were asked to answer the following questions based on their assigned group: Group A: Your doctor informs you that you have a rotator cuff tear and states that if he/she surgically repairs your cuff tear you will improve and that the cuff remains healed at the 2-year follow-up in 71% of the cases where surgery is done. Would you choose surgery? Yes or No Group B: Your doctor informs you that you have a rotator cuff tear and that if he/she surgically repairs your cuff tear you will improve and that the cuff is torn again at 2-year follow-up in 29% of the cases where surgery is done. Would you choose surgery? Yes or No Age, gender, the shoulder affected and the functional status assessed through the Constant score were also recorded. Results 80 patients were randomized (43 to group A and 37 to group B). The patients assigned to group A (benefit) accepted surgery significantly more frequently than those assigned to group B (complication) ( P = 0.000). In group A, 36 of 43 (84%) accepted surgery, compared to 17 of 37 (46%) in group B. Conclusions The way that information on rotator cuff disorders is provided strongly influences patients’ treatment decisions. Trial registration ClinicalTrials.gov, NCT03205852 . Registered 29 June 2017. Retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Do we really allow patient decision-making in rotator cuff surgery? A prospective randomized study

Torrens¹,

Miquel²,

Santana³

2019

J Orthop Surg Res

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“…We defined agreement as 9 or more of 11 (.80%) respondents answering in the same manner. [16][17][18][19][20] We compared the surgeon's responses against 8 reference cases previously determined to be stable or unstable on EUA by agreement 13 to determine whether radiographs alone were sufficient to identify instability. Eight cases analyzed by 11 expert reviewers allowed for 88 possible reviewer choices.…”

Section: Methodsmentioning

confidence: 99%

Examination Under Anesthesia Improves Agreement on Mechanical Stability: A Survey of Experienced Pelvic Surgeons

Tucker

Carney

Nguyen

et al. 2021

Journal of Orthopaedic Trauma

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Objectives: To assess agreement among experts in pelvic fracture management regarding stability and need for operative repair of lateral compression-type pelvic fractures with static radiographs compared to static radiographs and examination under anesthesia (EUA).Setting: Online survey.Patients/Participants: Ten patients who presented to our level-1 trauma center with a pelvic ring injury were selected. Vignettes were distributed to 11 experienced pelvic surgeons. Intervention: Examination under anesthesia.Main Outcome Measurements: Agreement regarding pelvic fracture stability and need for surgical fixation.Results: Agreement on stability was achieved in 4 (40%) cases without EUA compared to 8 (80%) cases with EUA. Interreviewer reliability was poor without EUA and moderate with EUA (0.207 vs. 0.592). Agreement on need to perform surgery was achieved in 5 (50%) cases compared to 6 (60%) cases with EUA. Interreviewer reliability was poor without EUA and moderate with EUA (0.250 vs. 0.432). For reference cases with agreement, surgeons were able to predict stability or instability using standard imaging in 57 of a possible 88 reviewer choices (64.8%) compared to 82 of 88 choices (93.2%) with the addition of EUA (P , 0.0001).Conclusions: EUA increased agreement among experienced pelvic surgeons regarding the assessment of pelvic ring stability and the need for operative intervention. Further research is necessary to define specific indications for which patients may benefit from EUA.

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Exploration of the Usual Care Pathway for Rotator Cuff Related Shoulder Pain in the Western Australian Workers’ Compensation System

et al. 2022

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Rotator cuff disease: opinion regarding surgical criteria and likely outcome

Abstract: Research is required to inform robust clinical practice guidelines for rotator cuff surgery. Identification of prognostic factors for successful surgical outcome is imperative.

Cited by 5 publications

References 32 publications

Do we really allow patient decision-making in rotator cuff surgery? A prospective randomized study

Do we really allow patient decision-making in rotator cuff surgery? A prospective randomized study

Examination Under Anesthesia Improves Agreement on Mechanical Stability: A Survey of Experienced Pelvic Surgeons

Exploration of the Usual Care Pathway for Rotator Cuff Related Shoulder Pain in the Western Australian Workers’ Compensation System

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