Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair

Daniels, Stephen D.; Stewart, Cory M.; Garvey, Kirsten D.; Brook, Emily M.; Higgins, Laurence D.; Matzkin, Elizabeth G.

doi:10.1177/2325967119881959

Cited by 36 publications

(26 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in this study the obtained data could be influenced by two inconsistent LHBT surgical procedures—tenotomy/tenodesis, which may have an impact on final results [ 42 ]. The smokers also had more often night pain, which also could be biased by the male/female ratio, since there were no females in the smoking population [ 43 ]. This field needs further research because there is no simple link between pain sensation and smoking habits [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

Zabrzyński

Huri

Gagat

et al. 2021

JCM

View full text Add to dashboard Cite

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

Zabrzyński

Huri

Gagat

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Recognizing gender disparities in PROs can be especially useful for analyzing operative indications, counseling patients preoperatively, setting patients' expectations, tracking operative outcomes, and possibly determining reimbursement. 6,8 Since 1993, the National Institute of Health (NIH) Revitalization Act has mandated the inclusion of women and minorities in clinical research. Since then, numerous studies have demonstrated the effect of gender on both clinical outcomes and PROs for a variety of conditions and procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Since then, numerous studies have demonstrated the effect of gender on both clinical outcomes and PROs for a variety of conditions and procedures. In the orthopedic literature, studies have been conducted evaluating the effect of gender on PROs and other outcomes for various orthopedic surgeries, including total knee arthroplasty (TKA), 3,11,25,26,31,35,44 total hip arthroplasty (THA), 3,4,12,26,35 total shoulder arthroplasty (TSA), 15 rotator cuff repair, 8 and others. 2,16 Considerable variability exists in gender-based outcomes for different orthopedic procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Although some non-ankle arthroplasty studies have found gender differences in functional outcomes, 4,5,12,19,25,44 others report no differences in postoperative outcomes between men and women. 8,11,15,31 A few studies similarly highlight poorer preoperative PRO scores and range of motion among females, which may result in a greater magnitude of improvement in postoperative scores. 4,5,11,19,25 Additionally, gender disparities have been found in postoperative complications following THA and TKA.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Gender Differences on Patient-Reported Outcomes and Complications in Total Ankle Replacement

et al. 2021

View full text Add to dashboard Cite

Background: The purpose of this study was to evaluate gender differences in patient outcomes and complications following total ankle replacement (TAR). Methods: Consecutive patients who underwent primary TAR from July 2007 through May 2016 were prospectively followed and retrospectively reviewed. Demographic, operative, patient-reported outcomes (PROs), and complication data were collected and analyzed. PROs included the visual analog scale (VAS), 36-Item Short-Form Health Survey (SF-36), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale, and Short Musculoskeletal Function Assessment (SMFA). A total of 475 patients were evaluated, including 248 males (52.2%) and 227 females (47.8%) with an average of 56.8 months follow-up. Results: Women were more likely to have inflammatory arthritis (13.7% vs 2.8%; P < .01) and significantly worse preoperative SF-36 total, SF-36 mental health component, AOFAS total, AOFAS pain, SMFA function, and SMFA bother scores (all P < .05). Both genders demonstrated significant improvement in PROs at 1, 2, and 5 years. The magnitude of improvement was similar between genders for all PROs (all P < .05) with the exception of SF-36 physical function, which was greater in men. Females underwent more nonrevision reoperations (32.2% vs 22.6%; P = .0191), but there was no significant difference in failure rates (male 7.3% vs female 3.5%; P = .07). The reoperation and failure rates at 2 years postoperation were 10.1% and 1.6% for men and 18.5% and 0.9% for women, respectively. Conclusions: Women undergoing TAR were more likely to have worse preoperative PROs and higher rates of nonrevision reoperations, which remains true when controlling for their increased incidence of inflammatory arthritis. However, women reported similar improvements in PROs and had similar prosthetic survival rates as men. Increased understanding of these disparities, combined with gender-based interventions, may further advance patient outcomes. Level of Evidence: Level III, therapeutic, retrospective comparative series

show abstract

“…Musculoskeletal disorders and injuries that are characterized by sexual dimorphism are not routinely considered by orthopedic surgeons when making treatment decisions [ 25 ]. This is surprising as sex differences in patient-related outcomes and functionality after orthopedic surgery are well described in the literature [ 26 , 27 , 28 , 29 ]. This observation might partly be caused by sex-specific postoperative morbidity and mortality [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Köppe

Katthagen

Rischen

et al. 2021

JCM

View full text Add to dashboard Cite

Aims: The best surgical treatment of multi-fragmentary proximal humeral fractures in the elderly is a highly controversial topic. The aim of this study is to assess for sex-related differences regarding mortality and complications after reverse total shoulder arthroplasty (RTSA) and locking plate fixation (LPF). Patients and Methods: All patients from the largest German healthcare insurance (26.5 million policy holders) above the age of 65 years that were treated with LPF or RTSA after a multi-fragmentary proximal humerus fracture between January 2010 and September 2018 were included. Multivariable Cox regression models were used to assess the association of sex with overall survival, major adverse events and surgical complications. Results: A total of 8264 (15%) men and 45,707 (85%) women were followed up for a median time of 52 months. After 8 years, male patients showed significantly higher rates for death (65.8%; 95% CI 63.9–67.5% vs. 51.1%; 95% CI 50.3–51.9%; p < 0.001) and major adverse events (75.5%; 95% CI 73.8–77.1% vs. 61.7%; 95% CI 60.9–62.5%; p < 0.001). With regard to surgical complications, after adjustment of patient risk profiles, there were no differences between females and males after LPF (p > 0.05), whereas men showed a significantly increased risk after RTSA (HR 1.86; 95% CI 1.56–2.22; p < 0.001) with more revision surgeries performed (HR 1.76, 95% CI 1.46–2.12; p < 0.001) compared to women. Conclusion: The male sex is an independent risk factor for death and major adverse events after both LPF and RTSA. An increased risk for surgical complications after RTSA suggests that male patients benefit more from LPF. Sex should be considered before making treatment decisions.

show abstract

Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair

Cited by 36 publications

References 36 publications

The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

Effect of Gender Differences on Patient-Reported Outcomes and Complications in Total Ankle Replacement

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Contact Info

Product

Resources

About