Systematic review of rotator cuff tears in workers' compensation patients

Kemp, Kyle; Sheps, David M; Luciak-Corea, Charlene; Styles-Tripp, Fiona; Buckingham, Jeanette; Beaupré, Lauren A

doi:10.1093/occmed/kqr068

Cited by 42 publications

(42 citation statements)

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“…The influence that compensation status has on the prognosis of patients undergoing surgical treatment for musculoskeletal disorders has been investigated by a number of clinical studies [2], [7], [22], [23] and systematic or meta-analytic reviews[24]–[27]. However, there are methodological flaws in the design of many of these studies which diminishes the confidence one may have in their findings.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are methodological flaws in the design of many of these studies which diminishes the confidence one may have in their findings. For example, two of the systematic reviews [24], [27] considered only disease-specific studies and were therefore limited to a very small number of studies. This approach leads to results that lack generalizability across patient populations.…”

Section: Introductionmentioning

confidence: 99%

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Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

et al. 2012

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IntroductionPrevious reviews have demonstrated that patient outcomes following orthopaedic surgery are strongly influenced by the presence of Workers’ Compensation. However, the variability in the reviews’ methodology may have inflated the estimated strength of this association. The main objective of this meta-analysis is to evaluate the influence of Workers’ Compensation on the outcomes of orthopaedic surgical procedures.MethodsWe conducted a systematic search of the literature published in this area from 1992–2012, with no language restrictions. The following databases were used MEDLINE (Ovid), Embase (Ovid), CINAHL, Google Scholar, LILACS and Pubmed. We also hand-searched the reference sections of all selected papers. We included all prospective studies evaluating the effect of compensation status on outcomes in adult patients who had undergone surgery due to orthopaedic conditions or diseases. Outcomes of interest included disease specific, region specific and/or overall quality of life scales/questionnaires and surgeons’ personal judgment of the results. We used an assessment tool to appraise the quality of all included studies. We used Review Manager to create forest plots to summarize study data and funnel plots for the assessment of publication bias.ResultsTwenty studies met our eligibility criteria. The overall risk ratio for experiencing an unsatisfactory result after orthopaedic surgery for patients with compensation compared to non-compensated patients is 2.08 (95% CI 1.54–2.82). A similar association was shown for continuous data extracted from the studies using assessment scales or questionnaires (Standard Mean Difference = −0.70 95% CI -0.97- −0.43).ConclusionsAmong patients who undergo orthopaedic surgical procedures, those receiving Workers’ Compensation experience a two-fold greater risk of a negative outcome. Our findings show a considerably lower estimate of risk compared to previous reviews that include retrospective data. Further research is warranted to determine the etiological explanation for the influence of compensation status on patient outcomes.Systematic Review Registration NumberCRD42012002121

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

et al. 2012

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“…These injuries have a significant negative effect on work productivity [ 11 , 12 ] and are often associated with poor surgical recovery [ 13 - 15 ]. Unfortunately, research studies focusing on shoulder injuries in adults have commonly been oversimplified in their representation of individuals injured in the workplace often categorizing injured workers based solely on their compensation status [ 16 ] rather than exploring type or severity of injury or reasons for failure to management. The classification of injured workers in this simplistic fashion may have contributed to inaccurate claims and perpetuated stigmas regarding the prognosis, treatment effect and overall outcomes of injured workers with disorders of the shoulder.…”

Section: Introductionmentioning

confidence: 99%

Examining outcome of early physician specialist assessment in injured workers with shoulder complaints

Razmjou

Boljanovic

Lincoln

et al. 2015

BMC Musculoskelet Disord

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BackgroundThere is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems. The purposes of this study were: 1) to document the demographics of patients with shoulder complaints referred to an Early Shoulder Physician Assessment (ESPA) Program and to describe the recommended management, and 2) to examine the relationship between patient characteristics and their subjective complaints of pain and functional difficulty.MethodsThis study involved a retrospective review of electronic files of injured workers mostly seen within the first 16 weeks of injury or recurrence. Measures of functional difficulty and pain were the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Numeric Pain Scale (NPS).ResultsFiles of 550 consecutive patients, 260 females (47%), 290 men (53%) were examined. The average age was 49 (SD = 11, range 22–77), with 28 (5%) patients being 65 years of age or older. Patients who were not working were the most disabled group based on Quick DASH (F = 49.93, p < 0.0001) and NPS (F = 10.24, p = 0.002). Patients who were working full time performing regular duties were the least disabled according to both measures, the QuickDASH (F = 10.24, p = 0.002) and NPS (F = 7.57, p = 0.006).Patients waiting more than 16 weeks were slightly older (53 years of age vs. 49, p = 0.045) than those who met the criteria for early assessment with similar levels of pain and functional difficulty. Biceps pathology had the highest prevalence (37%). Full thickness tear had a prevalence of 14%. Instability, labral lesions and osteoarthritis of glenohumeral joint were uncommon conditions (3, 2 and 1% respectively). Fifty-five patients (10%) were surgical candidates and had higher scores on QuickDASH (F = 7.16, p = 0.008) and NPS (F = 4.24, p = 0.04) compared to those who did not require surgery.ConclusionsThis study provides information on characteristics and prevalence of important variables in injured workers with shoulder problems and highlights the impact of these characteristics on pain and disability.

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“…There is a significant disease burden attached to painful tendinopathy not only in terms of healthcare costs, but also in terms of time off work and impact on patients' quality of life [44]. Therefore, the effective treatment of painful tendinopathy has a huge potential to save money and improve quality of life [38]. In general, the etiology of these tendinopathies remains unclear, although the commonly affected tendons all experience high levels of mechanical stress [48] and overuse is a frequently implicated risk factor [26].…”

Section: Introductionmentioning

confidence: 99%

The Peripheral Neuronal Phenotype is Important in the Pathogenesis of Painful Human Tendinopathy: A Systematic Review

Dean

Franklin

Carr

2013

Clinical Orthopaedics &Amp; Related Research

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Systematic review of rotator cuff tears in workers' compensation patients

Cited by 42 publications

References 20 publications

Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

Examining outcome of early physician specialist assessment in injured workers with shoulder complaints

The Peripheral Neuronal Phenotype is Important in the Pathogenesis of Painful Human Tendinopathy: A Systematic Review

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