Failed subacromial decompression. Risk factors

Bouchard, A.; Garret, Jérôme; Favard, Luc; Charles, H Bernard; Ollat, D.

doi:10.1016/j.otsr.2014.09.006

Cited by 27 publications

(7 citation statements)

References 18 publications

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“…In this study, we found that 35.6% (95% CI 26.4–45.8%) of patients still report pain 6 months after surgery. Thus, our findings are in accordance with the results from a retrospective study including 108 patients in which as many as 31 patients (29%) had >3 on a visual analogue scale score 6 months after ASD surgery [24]. Other studies have reported failure rates of 16–25% [4, 5, 7–12].…”

Section: Discussionsupporting

confidence: 91%

“…We found an association between ongoing insurance case, unemployment, and general tendency to worry (t-STAI) with unexplained persistent pain 6 months after surgery. Previous studies have shown that patients with workers’ compensation have lower shoulder-specific measures (e.g., DASH) and general health measures before and after surgery and have worse outcomes [24, 27, 28]. Even though the underlying factors for the association between a poor outcome and an ongoing insurance case is not fully understood, it is important to be especially aware of patients with ongoing insurance cases.…”

Section: Discussionmentioning

confidence: 99%

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High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

Brix

Thillemann

Bjørnholdt

et al. 2019

SICOT-J

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Purpose: The aims of this prospective study were to determine the prevalence of pain 6 months after arthroscopic subacromial decompression (ASD) and/or acromioclavicular joint resection (AC resection), to reveal causes of the pain, and to identify risk factors for persistent pain. Methods: Preoperatively, patients were tested for their endogenous capacity to modulate pain and completed questionnaires concerning psychological vulnerability. Patients with pain 6 months after surgery were examined by an experienced orthopaedic surgeon to reveal any shoulder pathology responsible for the pain. Results: Data from 101 patients were available for analysis 6 months after surgery. Thirty-six patients had persistent pain: 32 underwent examination by the surgeon who identified shoulder pathology in ten patients, but not in the remaining 22 in whom ongoing insurance case, unemployment, and a general tendency to worry were risk factors for persistent pain. Conclusion: The prevalence of persistent pain 6 months after ASD and/or AC resection was 35.6% (95% CI 26.1–45.8%) and the proportion of patients with shoulder pathology was 9.9%. An association between ongoing insurance case, unemployment, general tendency to worry (t-STAI), and unexplained persistent pain 6 months after surgery was found.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

Brix

Thillemann

Bjørnholdt

et al. 2019

SICOT-J

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“…The prolonged recovery and worse outcomes in compensated patients likely leads to more health-care utilization and subsequently higher costs of care after work-related shoulder injuries. 12 - 17 The slow recovery and lower outcome scores would be expected to result in more therapy, potentially more imaging, and more physician office appointments relative to noncompensated patients. The data in this study were generated from large cohorts, with overall health-care costs averaging around US $30 000 by the time the average worker returned to full-time work, with arthroscopy being slightly more expensive.…”

Section: Discussionmentioning

confidence: 99%

A Review of a Workers’ Compensation Database 2003 to 2013: Patient Factors Influencing Return to Work and Cumulative Financial Claims After Rotator Cuff Repair in Geriatric Workers’ Compensation Cases

Shields

Thirukumaran

Noyes

et al. 2017

Geriatr Orthop Surg Rehabil

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Background:Workers’ compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers’ compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques.Methods:An all workers’ compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60. Primary outcomes were the number of days for return to full work (RTW) following surgery and the total reimbursement for health care. Multivariate analysis was performed, and data are presented as average ± standard deviation.Results:The database yielded 1903 claims for surgically treated rotator cuff conditions (arthroscopic n = 935; open n = 926; both n = 42). In multivariate RTW analyses, we did not find a significant difference between groups (RTW in days was 153 ± 134 for arthroscopy [P = .81], 160 ± 160 for open [Ref], and 140 ± 82 days for both [P = .75]). However, multivariate analysis of reimbursement claims found arthroscopic surgery claims to be 13% higher compared to claims for open surgery only (US $29 986 ± 16 259 for arthroscopy vs US $26 495 ± 13 186 for open, P < .001). Patients aged ≥65 had more medical expenses than patients aged 60 to 64 (P = .03). Potentially modifiable variables that significantly prolonged RTW timing and higher health-care claims included need for vocational rehabilitation services and filing of a legal suit.Conclusions:Return to full-duty work in geriatric workers’ compensation patients after rotator cuff repair takes about 5 months regardless of surgical approach and costs significantly more in patients aged ≥65. Arthroscopic repairs generated 13% more cumulative health-care costs than open surgery alone. More efficient vocational rehabilitation services and minimizing legal suits may help get patients back to work sooner and reduce overall costs.

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“…Bouchard et al prescribed some factors for any fail of ASD surgery [20]. We believe there is a much greater chance of success in a decompression performed with meticulous attention to anatomy by placing markers for particular regions (such as a needle inserted in AC joint).…”

Section: Discussionmentioning

confidence: 97%

The Role of Arthroscopic Decompression in Subacromial Impingement Syndrome

Atik

2019

Acta Medica Alanya

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Bu çalışmanın amacı, rotator manşet tendonları üzerine korakoakromiyal arkın basısı ile karakterize subakromiyal sıkışma sendromu tanısı ile artroskopik subakromiyal dekompresyon yapılan hastaların klinik sonuçlarını değerlendirmektir. Hastalar veYöntem: En az altı ay konservatif tedavi uygulamalarından fayda görmeyen ve artroskopik subakromial dekompresyon uyguladığımız 25 hastanın, tedavi öncesi ve cerrahi sonrası 15. gün ve 6. aydaki Constant, istirahat VAS ve hareket VAS skorlarını değerlendirdik. Bulgular: Ameliyat öncesi ve 15. gün / 6. ay skorları arasında Mann Whitney U testi ile istatistiksel olarak anlamlı bir fark vardı (p <0.0001). Hastaların ağrılarının azaldığını ve omuz fonksiyonlarında iyileşme olduğunu istatistiksel olarak tespit ettik. Sonuç: Erken evre subakromial sıkışma sendromunun tedavisinin konservatif olduğu; ancak, 6 ay konservatif tedaviye rağmen şikayetleri devam eden hastalarda artroskopik subakromial dekompresyonun iyi bir tedavi seçeneği olduğu kanaatindeyiz.

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Failed subacromial decompression. Risk factors

Abstract: IV (retrospective study).

Cited by 27 publications

References 18 publications

High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

A Review of a Workers’ Compensation Database 2003 to 2013: Patient Factors Influencing Return to Work and Cumulative Financial Claims After Rotator Cuff Repair in Geriatric Workers’ Compensation Cases

The Role of Arthroscopic Decompression in Subacromial Impingement Syndrome

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