Variation among Argentinean orthopedic surgeons in the therapeutic indications for rotator cuff tears

Abstract

Introduction: Indications in the operative and nonoperative treatment of rotator cuff tears are widely discussed and not standardized. The aim of this study is to evaluate the variability among Argentinean orthopedic surgeons regarding the indications of treatment for different rotator cuff injuries.
 Materials and Methods: A questionnaire was developed based on the study carried out by Dunn et al. Our aim was to gather the opinions of Argentinean orthopedic surgeons on decision-making concerning thetreatment of different rotator cuff lesions. The questionnaire was sent to 2 groups: general orthopedic surgeons and shoulder specialist surgeons, included according to the number of shoulders treated surgically and non-surgically in 2017. The questionnaire has two sections: 4 hypothetical clinical cases and 11 questions on factors that could influence treatment selection.
 Results: Out of 556 questionnaires sent, 162 were completed, 117 by general orthopedic surgeons and 45 by shoulder specialists. The specialists reported mostly arthroscopic repairs (60%), general orthopedic surgeons reported repairing these injuries mainly by mini-open or by standard open technique (49% and 22% respectively). The failure rate was considered to be 20%, not evidencing differences between professionals (P=0.42). There was also agreement in the contraindication of the use of corticosteroids before surgery(P=0.74).
 Conclusion: This study evidences significant variability in the management of these patients (for which we selected potentially controversial injuries), making it difficult to establish protocols or consensus guidelines to help standardize treatments for these injuries.
 Level of evidence: IIb