Rates of Return to Manual Labor After Arthroscopic Rotator Cuff Repair

Abstract

Background: Rotator cuff tears represent a significant cause of shoulder pain and dysfunction in the United States. The development of these injuries is associated with older patient age and higher levels of physical activity; however, data regarding the rate of return to work after arthroscopic rotator cuff repair in patients older than 50 years of age who have physically strenuous jobs is inconclusive. Purpose/Hypothesis: The purpose of this study was to report short term outcomes and return to work rates after arthroscopic rotator cuff repair in a cohort of patients aged 50 to 60 years working in manual labor jobs. It was hypothesized that arthroscopic rotator cuff repair would result in good functional outcomes for these patients and allow for return to work rates in excess of 80%. Study Design: Case series; Level of evidence, 4. Methods: Preoperative and final evaluations including the pain visual analog scale (VAS), the Single Assessment Numeric Evaluation (SANE), and the American Shoulder and Elbow Surgeons (ASES) Shoulder Score were collected. A total of 73 patients were screened for inclusion. Nineteen patients were outside of the inclusion age range, 2 underwent exclusionary concomitant procedures, and 4 patients were lost to follow up, leaving a total of 48 patients with a mean follow up of 34.02 months (range, 24-67 months) available for analysis. None of the patients were involved in a workers’ compensation claim. Subgroup analysis was performed to determine if arm dominance or tear size affected surgical outcomes or return to work rates. Results: After arthroscopic rotator cuff repair, 43 of 48 patients (89.6%) were able to return to manual labor positions. Tears were classified using the Southern California Orthopaedic Institute Classification at the time of repair as massive (C4) in 9 patients (18.75%), large (C3) in 13 patients (27.08%), medium (C2) in 21 patients (43.75%), and small (C1) in 5 patients (10.42%). At latest follow up, the mean VAS decreased from 8.0 ± 1.81 to 0.46 ± 1.20, the average SANE increased from 47.50 ± 18.59 to 91.88 ± 12.30, and the average ASES score improved from 39.58 ± 10.71 to 93.44 ± 11.97 ( P < .0001). Outcomes did not differ between patients who underwent surgery on their dominant shoulder and those who underwent surgery on their nondominant shoulder. The overall postoperative complication rate was 8.33%. Conclusion: Arthroscopic rotator cuff repair portended favorable outcomes and high rates of return to work in this cohort of manual laborers, with 89.6% of patients able to return to work.

Arthroscopic rotator cuff repair: patients with physically demanding work have significantly worse time to return to work, level of employment, and job loss

“…The irst aspect taken into consideration in this study was the time to RTW: with a retrieved mean of 4.7 months, which appears to be in line with the majority of the literature, that reports a range of 5-11 months [15,18,30]. It is not surprising that the time to RTW progressively increased as the physical efort increased, as underlined by Novè-Josserand et al [26], who reported a time away from fulltime work of 7 months for non-manual workers, 9.2 months for manual workers, and 11.2 months for heavy manual workers.…”

Effect of Retear After Arthroscopic Rotator Cuff Repair on Return to Work and Sports in Nonathletes: A Retrospective Cohort Study

“…However, only 57.6% of the intact group and 56.2% of the retear group in our study population could fully return to their previous work without limitations in intensity or time, and only 50.0% of the intact group and 23.1% of the retear group could fully return to their preinjury level of sports. These rates are lower than previously reported in other studies that reported return-to-work rates of approximately 62.3% to 89.6% 17,20 and return-tosports rates of approximately 65.9% to 93%. [3][4][5][6]31 This difference may be because of our study design, which had patients self-report their work and sports status without controlling for personal bias or secondary gain.…”

Predictive factors of return‐to‐work trajectory after work‐related rotator cuff syndrome: A prospective study of 96 workers

“…Furthermore, and to the best of our knowledge, except for Green et al 20 the literature does not mention the surgical repair of a ruptured tendinopathy—retained in our study in the multiple factor model—as a factor favorable to return to/remain at work; it is a major surgical procedure, causing a longer duration of immobilization and a longer duration of complete recovery 25 than for a nonruptured tendinopathy. At the preoperative stage, this variable did not predict the duration of time off work postsurgery 28 .…”

“…By contrast, with a mean follow-up of 34 months, Green et al 20 concluded that 89.6% of manual workers were able to return to work after arthroscopic rotator cuff repair.…”

“…According to Gutman et al, 19 nearly one‐third of workers were unable to return to work. By contrast, with a mean follow‐up of 34 months, Green et al 20 concluded that 89.6% of manual workers were able to return to work after arthroscopic rotator cuff repair.…”