Minimum 15-year follow-up for clinical outcomes of arthroscopic rotator cuff repair

Nicholson, Allen D.; Estrada, Jennifer; Mathew, Joshua I.; Finocchiaro, Anthony; Pinnamaneni, Sridhar; Okeke, Laurence; Dines, David M.; Dines, Joshua S.; Taylor, Samuel A.; Warren, Russell F.; Cordasco, Frank A.; Rodeo, Scott A.; Gulotta, Lawrence V.

doi:10.1016/j.jse.2022.01.116

Cited by 13 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most recently, Nicholson et al reported on the clinical outcomes of 60 patients with a mean age of 58.1 year (range 37-75) treated with arthroscopic RCR at a minimum of 15 years (mean 16.5 years) follow-up. 29 Similar to our findings, they reported that there were no significant differences between the short- and long-term patient reported outcomes. While they found that male sex and younger age were associated with higher Shoulder Activity Scales, they did not find any factors that were predictive of ASES and Single Assessment Numeric Evaluation scores.…”

Section: Discussionsupporting

confidence: 91%

Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less

Green¹,

Loyd²,

Molino³

et al. 2023

JSES International

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 91%

Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less

Green¹,

Loyd²,

Molino³

et al. 2023

JSES International

View full text Add to dashboard Cite

“…The diminishing positive effect of arthroscopic rotator cuff repair on PROMIS scores in the current study is likely due to an overrepresentation of poor responders at later follow-up, because patients who were doing well postoperatively were discharged from routine clinical evaluation between 6 and 12 months postoperatively. After rigorous attempts to obtain long-term follow-up through telephone encounters and digital PROs, Nicholson et al 16 reported that 60 of 193 patients who underwent arthroscopic rotator cuff repair surgery reported maintenance of improved legacy PROs from preoperatively to 15 years postoperatively, which is consistent with the expected durable response to surgery seen in clinical practice.…”

Section: Discussionmentioning

confidence: 76%

Effect of Insurance Reimbursement Status on Pre- and Postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Scores After Arthroscopic Rotator Cuff Repair

et al. 2023

View full text Add to dashboard Cite

Background: Previous studies reported inferior patient-reported outcomes (PROs) after arthroscopic rotator cuff repair for patients receiving workers’ compensation (WC) relative to patients with commercial insurance. The extent to which alternative insurance reimbursement, including Medicaid and Medicare, influences outcomes after arthroscopic rotator cuff repair remains understudied. Hypothesis: Compared with patients with commercial insurance reimbursement, patients with WC or government-issued reimbursement would report lower pre- and postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) scores, report higher pre- and postoperative PROMIS Depression (D) and Pain Interference (PI) scores, and experience smaller levels of improvement in all PROMIS domains with surgical intervention. Study Design: Cohort study; Level of evidence, 3. Methods: Demographic and surgical data were extracted from the medical record, and PROMIS domains were prospectively collected. Patients were divided into cohorts based on insurance reimbursement status. Differences between insurance-based cohorts for baseline variables, pre- and postoperative PROMIS scores, and change from baseline to final follow-up (delta) for PROMIS scores were evaluated using Kruskal-Wallis or chi-square tests. Mixed-effects linear regression models were performed to assess the influence of insurance while controlling for other variables. Survival analysis was performed to determine time to achieve minimal clinically important difference (MCID) for each PROMIS domain per cohort. Results: 1252 patients underwent arthroscopic rotator cuff repair, met inclusion criteria, and completed PROMIS questionnaires. Statistically significant differences were noted in demographic variables including age ( P < .001), sex ( P < .001), ethnicity ( P < .001), and body mass index ( P < .001) between insurance-based cohorts. Unadjusted analysis revealed significantly higher PF scores and lower PI and D scores for the group with commercial insurance relative to those with Medicare, Medicaid, and WC at 6- and 12-month follow-up ( P < .01 all comparisons), except for the Medicare versus commercial subcohort analysis for PI at 6 months ( P = .28). These differences persisted for the Medicare, Medicaid, and WC groups ( P < .03 all comparisons) after adjustment for confounding variables in linear regression. Conclusions: The baseline characteristics of patients undergoing arthroscopic rotator cuff repair differed based on insurance reimbursement. Patients with commercial insurance reported improved physical function, decreased pain interference, and improved mood (less depression) relative to patients with government-issued and WC insurance, with maximum improvement 6 to 12 months postoperatively. There were few significant differences between insurance groups in change of PROMIS scores from preoperative to postoperative intervals, indicating that differences in the baseline demographic and surgical characteristics of these groups accounted for differences in response to surgery.

show abstract

“…However, in terms of the primary outcome (retear rate), the vast majority of retears occurs within the first 6 months post‐repair, and very few thereafter, suggesting a 12‐month assessment is appropriate [20]. In terms of clinical outcome, a recent long‐term study showed that the functional outcome at 12 months is significantly improved compared to baseline with no further change after 12 months [19]. It concludes that patients who maintain these improvements and have a good outcome at five years will also have a good result at 15 years, but such longitudinal follow‐up requires significant funding and is associated with logistical challenges.…”

Section: Discussionmentioning

confidence: 99%

A pilot randomised controlled trial assessing standard versus dermal patch-augmented rotator cuff repair found no adverse effects and suggest future trials need a minimum of 150 patients

Snow

Kuiper

James

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The aims of this pilot randomised controlled trial (RCT) were to assess the safety and eicacy of a human dermal allograft patch and assess the feasibility of a future RCT comparing retear rate and functional outcome 12 months following standard and augmented double-row rotator cuf repair. Methods A pilot RCT was conducted among patients undergoing arthroscopic repair of rotator cuf tear measuring between 1 and 5 cm. They were randomised to either augmented (double-row repair with human acellular dermal patch) or standard (double-row repair only). The primary outcome was rotator cuf retear determined on MRI scan at 12 months using the Sugaya's classiication (grade 4 or 5). All adverse events were recorded. Functional assessment was performed at baseline and 3, 6, 9, and 12 months post-surgery using clinical outcome scores. Safety was assessed by complications and adverse efects, and feasibility by recruitment, follow-up rate and proof of concept statistical analyses of a future trial. Results Between 2017 and 2019, 63 patients were considered for inclusion. Twenty-three patients were excluded, leaving 40 patients (20 per group) in the inal study population. The mean tear sizes were 3.0 cm in the augmented and 2.4 cm in the standard group. There was one adhesive capsulitis in the augmented group, with no other adverse events. Retear was observed in 4/18 (22%) of patients in the augmented and 5/18 (28%) in the standard group. In both groups, functional outcome improved signiicantly which was clinically meaningful for all scores, with no diference between groups. Retear rate increased with tear size. Future trials are feasible but need a minimum total sample size of 150 patients. Conclusion Clinically meaningful improved function without adverse efects was found with human acellular dermal patchaugmented cuf repairs. Level of evidence Level II.

show abstract

Minimum 15-year follow-up for clinical outcomes of arthroscopic rotator cuff repair

Cited by 13 publications

References 29 publications

Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less

Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less

Effect of Insurance Reimbursement Status on Pre- and Postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Scores After Arthroscopic Rotator Cuff Repair

A pilot randomised controlled trial assessing standard versus dermal patch-augmented rotator cuff repair found no adverse effects and suggest future trials need a minimum of 150 patients

Contact Info

Product

Resources

About