New work from Hospital for Special Surgery (HSS) pegs complication rates for rotator cuff repair.
The study, “Risk Factors for Short-term Complications After Rotator Cuff Repair in the United States,” appears in the April 2018 edition of Arthroscopy.
William W. Schairer, M.D., orthopedic surgery resident at Hospital for Special Surgery and co-author, told OTW, “Rotator cuff tears are common in older patients, and can cause pain and weakness that limit activity. As our techniques for repair get better and older patients are increasingly looking to maintain active lifestyles, the number of procedures to fix rotator cuff tears is increasing every year.”
“Despite the increases in surgery for older patients, we were surprised to find that there were very few studies looking at the complications in older adults. While most patients do very well after surgery, we occasionally see patients that have a prolonged recovery because of a medical complication.”
“We performed this study from a large population of Medicare patients so that surgeons would have real numbers regarding possible complications that they can discuss with their patients who are considering having surgery to fix their rotator cuff tear.”
“Overall we found that 1.4% of patients had some sort of complication after surgery. While this is a relatively small probability, knowing that 1 to 2 out of every 100 patients may experience a problem is a helpful number to quote patients.”
“Furthermore, we saw that about half the complications were serious in nature. The most common complication was an infection, which was also the leading reason for patients needing to go back to the operating room.”
“We also found a number of risk factors that increased the risks of complications, but they were not necessarily the same types of complications. For example, patients can have a complication directly related to their shoulder, such as an infection, or they may have other medical problems that may be exacerbated after having surgery that could cause them to be readmitted back to the hospital.”
“For example, the biggest risk factors for hospital readmission were congestive heart failure and dialysis, but there were many other medical problems that are linked to hospital readmission. It is important for patients and their surgeons to incorporate the full picture of a patient’s health status, both regarding their shoulder and also all of their medical problems that they are treated for. Patients with more medical problems have a higher likelihood of requiring hospitalization, even after an ambulatory surgery procedure such as a rotator cuff repair.”
“For patients that are considering orthopedic surgery, it is important for surgeons to also discuss the importance of their non-orthopedic medical problems and how these can influence their risk for complications after surgery. For older adults, it is important that decisions to proceed with surgery be made in close discussion with their primary medical doctor to ensure that everything is appropriately managed to help reduce their risk of complications after surgery.”
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