Does arthroscopic rotator cuff repair improve patients' activity levels?

Baumgarten, Keith M.; Chang, Peter S.; Dannenbring, Tasha M.; Foley, Elaine K.

doi:10.1016/j.jse.2018.04.010

Cited by 5 publications

(5 citation statements)

References 39 publications

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“…For a surgical technique that was published in 1996, there is not an abundance of studies that examine margin convergence rotator cuff repair, with most of the literature published by the author and institution that popularized the technique. 2 , 3 , 4 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Biomechanical studies have shown that margin convergence techniques decrease gap formation and may provide a better mechanical environment for rotator cuff healing. 5 , 6 , 7 Mazzocca et al.…”

Section: Discussionmentioning

confidence: 99%

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Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Baumgarten

2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To determine whether patients who require margin convergence would have equivalent postsurgical patient-determined scores compared with patients with standard rotator cuff repair. The secondary purpose of this study was to determine whether the short-term results found for patients with margin convergence repairs would be durable through medium-term follow-up. Methods A retrospective analysis of patients undergoing arthroscopic rotator cuff repair was performed to examine the effects of marginal convergence on patient-determined outcomes (Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, Single Assessment Numeric Evaluation, and Shoulder Activity Level). Patient-determined outcomes in patients who had margin convergence repairs were compared with patients who had standard rotator cuff repair. Prospective follow-up of patients that had margin convergence repairs was performed to determine whether patient-determined outcomes deteriorated over time. Results Two-hundred-seventy-two patients had standard rotator cuff repairs and 9 patients had margin convergence rotator cuff repair (3.2%). All patients had significant improvements in their Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and Single Assessment Numeric Evaluation. Patients requiring margin convergence rotator cuff repair had similar preoperative and postoperative scores compared with patients with a standard rotator cuff repair. At a mean follow-up of 7.5 years, there was no change in outcome scores compared with the early follow-up time point (mean 3.3 years) for patients undergoing margin convergence. Conclusions Arthroscopic margin convergence repair techniques along with the treatment of concomitant pathologies result in similar patient-determined outcomes compared with standard rotator cuff repair techniques. These results appear to be durable and do not deteriorate from short-term to medium-term follow-up. Level of evidence III: Retrospective comparative study

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Section: Discussionmentioning

confidence: 99%

“…In addition, the Shoulder Activity Level was the primary activity level score outcome examined in this study since it is a validated, patient-determined outcome score that can be used to measure a patient’s activity level. 19 , 20 , 21 …”

Section: Methodsmentioning

confidence: 99%

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Baumgarten

2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Data from this registry have been included in previously published manuscripts. 5 , 6 Inclusion criteria were patients that had an arthroscopic rotator cuff repair and had a preoperative and/or postoperative ASES score recorded simultaneously with a WORC score. All outcome scores were completed in a pen-and-paper format.…”

Section: Methodsmentioning

confidence: 99%

“… 4 Both scores are commonly used simultaneously to assess outcomes in patients with rotator cuff tears. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

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confidence: 99%

The American Shoulder and Elbow Score Is Highly Correlated With the Western Ontario Rotator Cuff Index and Has Less Responder and Administrator Burden

Baumgarten

Barthman

Chang

2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To compare the correlation, responsiveness, and responder and administrator burdens of the American Shoulder and Elbow Score (ASES) with the Western Ontario Rotator Cuff Index (WORC) for patients undergoing arthroscopic rotator cuff repair to determine whether one score is superior to the other to limit the use of multiple scoring measures when tracking patient outcomes. Methods A retrospective review of a database of patients undergoing arthroscopic rotator cuff repair was reviewed where the ASES was simultaneously recorded with the WORC. Correlations were determined using the Pearson coefficient. Subgroup analysis was performed to determine if correlations differed in (1) preoperative outcome and (2) postoperative outcome determinations. Responsiveness was determined by calculating the standardized response mean and the effect size of both scores. Responder and administrator burden was examined using 50 consecutively scored WORC and ASES scores by determining the number of questions accurately answered and the length of time taken to score each questionnaire. Results Correlation was excellent for the ASES and WORC (r = 0.90). The correlation of preoperative scores was strong-moderate (r = 0.69), and the correlation of postoperative scores was excellent (r = 0.86). The standardized response mean WORC = 2.3; ASES = 2.2) and the effect size (WORC = 2.9; ASES = 2.8) demonstrated comparable responsiveness. In total, 71.5% of the WORC questions were able to be scored compared with 93.3% for the ASES ( P < .0001). The mean time to score the WORC was significantly greater than the ASES (154 vs 23 seconds; P < .0001). Conclusions There is excellent correlation and comparable responsiveness between the ASES and WORC. Since there is greater responder and administrative burden for the WORC score, the authors recommend using the ASES over the WORC in patients undergoing rotator cuff repair. Level of Evidence Level IV, diagnostic series.

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“…Similar recommendations surround timing and indication of injection intervention, most guidelines recommending injection after 6-12 weeks, only if initial management has failed (Codsi & Howe, 2015;Diercks et al, 2014;Hopman et al, 2013). The current research shows comparable outcomes for surgical intervention versus clinician-led exercise, but surgery incurs much greater risk and cost than exercise treatment (Baumgarten et al, 2018;Codsi & Howe, 2015;Diercks et al, 2014;Hopman et al, 2013;Ketola et al, 2009;Kuhn et al, 2013;Piper et al, 2018;Saltychev et al, 2015). As such, guidelines recommend surgical opinion should only be considered after failure of 12 weeks of trialling initial management (Codsi & Howe, 2015;Diercks et al, 2014;Hopman et al, 2013).…”

Section: Introductionmentioning

confidence: 87%

French physiotherapy management of rotator cuff related shoulder pain: An observational study

Riera

Smythe

Malliaras

2021

Musculoskeletal Care

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Background: Rotator cuff related shoulder pain (RCRSP) is a common and disabling cause of shoulder pain contributing to great socio-economic costs. Conservative management is recommended as first-line treatment, with studies performed in the United Kingdom, Belgium, the Netherlands and Australia finding practice generally consistent with guideline recommendations. Current French guidelines for management of RCRSP were published more than a decade ago, and it is unknown if French physiotherapists manage RCRSP in line with the current guideline recommendations. The aim of this survey is to evaluate if management delivered by French physiotherapists for RCRSP is in line with the current evidence. Methods:A cross-sectional online survey was conducted and disseminated through various social media platforms and a mailing list from December 2018 to March 2019.Results: Two hundred and six French physiotherapists completed the survey. The results demonstrated that the majority of physiotherapists provide care consistent with recommended guideline management, through the delivery of exercise and education. Ideology and specific parameters of treatment delivery, particularly exercise treatment, were highly variable among the cohort, but comparable to findings among physiotherapists in the United Kingdom, Belgium, the Netherlands and Australia. Conclusion:French physiotherapists are broadly consistent with providing guideline recommended care of RCRSP; however, heterogeneity exists in the ideals and practice of specific treatment delivery, particularly within exercise management.

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Does arthroscopic rotator cuff repair improve patients' activity levels?

Cited by 5 publications

References 39 publications

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

The American Shoulder and Elbow Score Is Highly Correlated With the Western Ontario Rotator Cuff Index and Has Less Responder and Administrator Burden

French physiotherapy management of rotator cuff related shoulder pain: An observational study

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