Anatomic total shoulder arthroplasty for patients receiving workers' compensation

Jawa, Andrew; Dasti, Umer; Fasulo, Sydney M.; Vaickus, Max; Curtis, Alan S.; Miller, Suzanne L.

doi:10.1016/j.jse.2015.04.017

Cited by 27 publications

(11 citation statements)

References 9 publications

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“…The results for Bankart repairs are comparable with those in other long-term studies, in which the RTW rates were 82% to 100% at 48 months 11 , 25 . In contradistinction, patients undergoing TSA or RTSA were significantly older and fewer returned to work, which is consistent with other studies evaluating return to work following shoulder arthroplasty, in which the RTW rates were 46% to 65% 2 , 12 , 13 , 26 , 27 .…”

Section: Discussionsupporting

confidence: 88%

“…Individual studies have revealed that the time to RTW has ranged between 2.4 and 10 months following arthroscopic rotator cuff repair 3 - 6 , 12 days and 14.2 weeks after acromioplasty 7 - 9 , 2.7 and 3.4 months after Bankart repair 10 , 11 , 1.4 and 4 months after RTSA 2 , 12 , and 3.1 and 13.1 months 2 , 14 after hemiarthroplasty; the time to RTW averaged 4.2 months after anatomic total shoulder arthroplasty (TSA) 13 and 5.1 weeks after calcific debridement 15 .…”

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confidence: 99%

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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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Section: Discussionsupporting

confidence: 88%

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confidence: 99%

Return to Work Following Shoulder Surgery

2020

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“…6,7 This increase in utilization highlights the importance of identifying risk factors for complications in order to minimize adverse outcomes. Many risk factors that have previously been identified are patient-specific, and include BMI, 12 DM, 24 age, 25 worker's compensation, 26 depression and anxiety, 27,28 smoking, 29 among others. 11,16,17 Alternatively, operative duration is of interest as it is a surgeon-specific risk factor that is potentially modifiable.…”

Section: Discussionmentioning

confidence: 99%

The effect of operative time on early postoperative complications in total shoulder arthroplasty: An analysis of the ACS-NSQIP database

et al. 2019

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Background Total shoulder arthroplasty has been demonstrated to be an effective treatment for arthritis of the glenohumeral joint. Prior studies have identified longer operative times as a risk factor for complications after numerous types of procedures. We hypothesized that increased operative time, in 20-min intervals, would be associated with complications following total shoulder arthroplasty. Methods Patients undergoing total shoulder arthroplasty from 2006 to 2015 were identified from the ACS-NSQIP database. Patient demographic information, perioperative parameters, and 30-day outcomes were retrieved. Pearson's Chi-square test and multivariate Poisson regression with robust error variance were used to analyze the relationship of operative time and outcomes. Results A total of 10,082 patients were included. Multivariate analysis revealed that for each increase in 20 min of operative time, there were significantly increased rates of any complication (relative risk (RR) 1.24, 95% confidence interval (CI) 1.19–1.26), anemia requiring transfusion (RR 1.33, 95%CI 1.26–1.4), peripheral nerve injury (RR 1.88, 95%CI 1.53–2.31), and urinary tract infection (RR 1.24, 95%CI 1.09–1.41). Discussion This study indicates that increasing operative time confers increased risk for postoperative complications following total shoulder arthroplasty. We anticipate the results of this manuscript will be used for provider education, policy decision-making, and potentially to derive algorithms that can improve safety and efficiency in total shoulder arthroplasty. Level of evidence III.

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“…In a recent report on 13 workers' compensation patients treated with TSA, only 1 patient returned to the same job, and 54% did not return to work. 26 In a study comparing 14 workers' compensation to a matched group of controls with all members treated with RSA, the workers' compensation group yielded a lower return-to-work rate (14.2%) than the controls (41.7%). 27 In a large study of 154 TSA patients, 14% returned to work, but specific jobs were not described in this analysis.…”

Section: Discussionmentioning

confidence: 99%

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Kurowicki

Rosas²,

Law³

et al. 2018

Am J Orthop

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Both anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are routinely performed for patients who desire to continuously work or participate in sports. This study analyzes and compares the ability of patients to work and partake in sports following shoulder arthroplasty based on responses to clinical outcome surveys. A retrospective review of the shoulder surgery repository was performed for all patients treated with TSA and RSA and who completed questions 9 and 10 on the activity patient self-evaluation portion of the American Shoulder and Elbow Surgeons (ASES) Assessment Form. Patients with a minimum of 1-year follow-up were included if a sport or work was identified. The analysis included 162 patients with TSA and 114 patients with RSA. Comparisons were made between TSA and RSA in terms of the specific ASES scores (rated 0-3) reported for ability to work and participate in sports and total ASES scores, and scores based on specific sports or line of work reported. Comparisons were also made between sports predominantly using shoulder function and those that do not. TSA patients had a 27% higher ability to participate in sports (average specific ASES score: 2.5 vs 1.9, P < .001) than RSA patients and presented significantly higher scores for swimming and golf. Compared with RSA patients, TSA patients demonstrated more ability to participate in sports requiring shoulder function without difficulty, as 63% reported maximal scores (P = .003). Total shoulder arthroplasty patients also demonstrated a 21% higher ability to work than RSA patients (average specific ASES scores: 2.6 vs 2.1, P < .001), yielding significantly higher scores for housework and gardening. Both TSA and RSA allow for participation in work and sports, with TSA patients reporting better overall ability to participate. For sports involving shoulder function, TSA patients more commonly report maximal ability to participate than RSA patients.

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Anatomic total shoulder arthroplasty for patients receiving workers' compensation

Cited by 27 publications

References 9 publications

Return to Work Following Shoulder Surgery

Return to Work Following Shoulder Surgery

The effect of operative time on early postoperative complications in total shoulder arthroplasty: An analysis of the ACS-NSQIP database

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

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