The effect of rotator cuff repair on early overhead shoulder function: a study in 1600 consecutive rotator cuff repairs

Robinson, Hayden A.; Lam, Patrick H.; Walton, Julie; Murrell, George A. C.

doi:10.1016/j.jse.2016.05.022

Cited by 16 publications

(30 citation statements)

References 16 publications

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“…5,7 Female sex was found to correlate with poor functional outcome in prior multiple linear regression analyses. 22,37 Although female sex was associated with shoulder function in our univariate analysis, it was not a significant prognostic factor when controlling for other relevant factors.…”

Section: Discussionmentioning

confidence: 55%

Prognostic Factors for Functional Outcome After Rotator Cuff Repair: A Prospective Cohort Study With 2-Year Follow-up

et al. 2018

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Background: Although shoulder function is reported to be generally good after rotator cuff repair, limited knowledge exists regarding which prognostic factors predict functional outcomes. Purpose: To identify pre- and perioperative predictors of functional outcomes after arthroscopic rotator cuff repair. Study Design: Case-control study; Level of evidence, 3. Methods: A cohort of 733 consecutive patients treated with rotator cuff repair between 2010 and 2014 in a single orthopaedics unit was included. Data were collected prospectively and included pre- and perioperative variables. Univariate and multivariable linear regression analyses were used to predict shoulder function at 2-year follow-up, as measured by the Western Ontario Rotator Cuff Index (WORC). Results: In total, 647 (88%) patients were followed for 25 ± 5 months (mean ± SD; range, 17-66 months). In the multivariable regression model, the adjusted R2 was 0.360, indicating that 36% of the variation in the WORC at final follow-up could be explained by this statistical model. The multivariable linear regression analysis revealed that the strongest positive independent predictors of shoulder function at 2 years were preoperative WORC and Constant-Murley score in the contralateral shoulder. The model also indicated that activities of daily living, age, subacromial decompression, and biceps surgery had independent positive associations with better shoulder function at 2 years. In addition, previous surgery in the ipsilateral or contralateral shoulder, smoking, partial rotator cuff repair, preoperative pain, and atrophy in the infraspinatus were all independent factors negatively associated with shoulder function after 2 years. The overall healing rate of complete repairs per magnetic resonance imaging was 80%. Conclusion: The most important finding of the present study was that the strongest prognostic factors for better WORC at 2-year follow-up were better preoperative WORC and Constant-Murley score in the contralateral shoulder. Although not all the prognostic factors identified in this study are modifiable, they can still be useful for guiding patients in shared decision making with the surgeon. This cohort study shows that if selection of patients is performed properly, it is possible to obtain a successful outcome.

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Section: Discussionmentioning

confidence: 55%

Prognostic Factors for Functional Outcome After Rotator Cuff Repair: A Prospective Cohort Study With 2-Year Follow-up

et al. 2018

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“…Arthroscopic techniques were utilized during acromioplasty for rotator cuff impingement 17 , Bankart repair and superior labral anterior to posterior (SLAP) repair 18 for labral tears/instability, calcific debridement 19 for calcific tendinitis, arthroscopic capsular release 20 for idiopathic adhesive capsulitis, arthroscopic rotator cuff repair 21 for rotator cuff tears, and synthetic polytetrafluoroethylene (PTFE) patch rotator cuff repair 22 for massive to irreparable rotator cuff tears. Open surgery was performed for the shoulder replacements, which included anatomical TSA, hemiarthroplasty 23 , and RTSA 24 .…”

Section: Methodsmentioning

confidence: 99%

Return to Work Following Shoulder Surgery

2020

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Background: There is limited information on patients’ ability to return to work (RTW) after the majority of shoulder surgical procedures. Methods: This study was a retrospective analysis of prospectively collected data on 1,773 consecutive patients who underwent shoulder surgery performed by a single surgeon from 2004 to 2017. A validated L’Insalata Shoulder Questionnaire was used to collect information on 32 preoperative factors, which were used for analysis. The questionnaire included the premorbid level of work and the levels preoperatively and at 6 months postoperatively. Results: Six months following the shoulder operations, 77% of the patients returned to work (40% with full duties and 37% with light duties). Concomitant rotator cuff repair and stabilization was associated with the highest RTW rate (90%) whereas some of the lowest RTW rates were associated with reverse total shoulder arthroplasty (56%) and total shoulder arthroplasty (71%). The highest rate of RTW with full duties was associated with debridement for calcific tendinitis (62%). Capsular release provided a significant improvement in work level (on a scale ranging from none to strenuous) from preoperatively to postoperatively (p = 0.0116). Older patients with stiffer shoulders who were not working preoperatively had the lowest RTW rate at 6 months. Conclusions: To our knowledge, this is the largest study of RTW outcomes of shoulder surgical procedures, and it showed that 4 out of 5 patients were able to RTW 6 months postoperatively with approximately half resuming full duties and half, lighter duties. Capsular release was the only procedure to result in a significant improvement in work level within 6 months. The best independent predictors of RTW were younger age, less stiffness, and working preoperatively. Level of Evidence: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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“…Although similar improvements were seen in range of motion and pain levels with overhead activity, supraspinatus and external rotation power were greater in the shoulders with intact repairs 84. Factors associated with retear were tears size and patient age 85.…”

Section: Tendon Healingmentioning

confidence: 62%