Most patients decide to undergo rotator cuff repair to improve shoulder function

SAN DIEGO — Research that explored the reasons that impacted patients’ decisions to undergo arthroscopic rotator cuff repair highlighted improvement to shoulder function as the main drive for most patients.

Christopher Hadley

Christopher Hadley, BS, presented the findings at the American Orthopaedic Society for Sports Medicine Annual Meeting. Hadley and colleagues prospectively enrolled 150 patients who underwent arthroscopic cuff repair. Preoperatively, patients were given a questionnaire to determine why they decided to undergo surgical repair. Investigators used an evidence-based review of rotator cuff literature and the Delphi technique to develop their survey. Patients rated factors based on importance in their decision to undergo surgery. Surgeons were given a Likert scale and were asked how strongly they recommended patients undergo surgery based on factors such as MRI results and age. Researchers used the American Shoulder and Elbow Society (ASES) score to assess shoulder function.

Results showed the patient-reported factors that impacted patients’ decisions to undergo surgery included functionality of the shoulder, surgeon recommendation and daily chronic pain. From baseline to 6 months postoperatively, the ASES score improved from 42.6 to 77. Compared to other factors a significant increase in ASES score was seen at 3 months postoperatively in patients who said their top reason for surgery was that they were unable to play a favorite sport or hobby. However, differences in outcomes were not significant during any other time point with regard to category importance.

According to a subgroup of male and female patients and older vs. younger patients, women compared with men decided to undergo repair more often due to inability to sleep and daily, chronic pain. Younger patients compared with older patients proceeded with repair more often due to inability to play a sport or hobby and the increased demands of work. There was no association between decision factors and final ASES scores. Higher baseline ASEs scores were seen in younger patients and male patients; although, at the final follow-up outcome measures were not different.

“Overall, the outcomes of arthroscopic rotator cuff repair did not appear to be determined by preoperative decision-making on [the] part of the patient,” Hadley said during his presentation. – by Monica Jaramillo

Reference:

Weekes D, et al. Paper 127. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 5-8, 2018; San Diego.

Disclosure: Hadley reports no relevant financial disclosures.