Brett D Owens1, Allison E Williams2, Jennifer M Wolf3. 1. Bay Pines VA Healthcare System, Bay Pines, FL, USA; Keller Army Hospital, West Point, NY, USA; F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA. Electronic address: owensbrett@gmail.com. 2. Bay Pines VA Healthcare System, Bay Pines, FL, USA. 3. Bay Pines VA Healthcare System, Bay Pines, FL, USA; Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT, USA.
Abstract
BACKGROUND: Technical advances have allowed arthroscopic rotator cuff repair to supplant open repairs with similar outcomes. However, few data exist to support the theoretical decrease in complications with the arthroscopic technique. METHODS: We used the Veterans Administration Surgical Quality Improvement Program database from the entire U.S. Veterans Administration system. We obtained perioperative data of all patients undergoing rotator cuff repair between 2003 and 2008. Single and multivariate analyses were performed to evaluate risk factors for perioperative complications associated with rotator cuff surgery. RESULTS: There were 6975 open rotator cuff repairs and 2918 arthroscopic rotator cuff repairs performed with similar patient age, gender breakdown, body mass index, and comorbidities. Complications occurred in the early postoperative period in 2.1% of the open repair group and 0.9% of the arthroscopic repair group (P < .0001). The prevalence of both superficial and deep wound infection was higher in the open group compared with the arthroscopic group (1% vs. 0.1% superficial, P < .0001; 0.3% vs. 0.1% deep, P = .11). Return to the operating room within the 30-day surveillance period occurred in 1.1% of the open repair patients compared with 0.5% of patients undergoing arthroscopic repairs (P < .0001). -Multivariate logistic regression analysis revealed that the arthroscopic group had a significantly lower risk of complications (P = .0001), a lower rate of superficial infection (P = .0002), a lower incidence of return to the operating room within 30 days (P = .007), and a lower risk of hospital readmission (P < .0001). CONCLUSION: Arthroscopic rotator cuff repair in the veteran population resulted in a lower incidence of perioperative complications compared with open repair. Published by Elsevier Inc.
BACKGROUND: Technical advances have allowed arthroscopic rotator cuff repair to supplant open repairs with similar outcomes. However, few data exist to support the theoretical decrease in complications with the arthroscopic technique. METHODS: We used the Veterans Administration Surgical Quality Improvement Program database from the entire U.S. Veterans Administration system. We obtained perioperative data of all patients undergoing rotator cuff repair between 2003 and 2008. Single and multivariate analyses were performed to evaluate risk factors for perioperative complications associated with rotator cuff surgery. RESULTS: There were 6975 open rotator cuff repairs and 2918 arthroscopic rotator cuff repairs performed with similar patient age, gender breakdown, body mass index, and comorbidities. Complications occurred in the early postoperative period in 2.1% of the open repair group and 0.9% of the arthroscopic repair group (P < .0001). The prevalence of both superficial and deep wound infection was higher in the open group compared with the arthroscopic group (1% vs. 0.1% superficial, P < .0001; 0.3% vs. 0.1% deep, P = .11). Return to the operating room within the 30-day surveillance period occurred in 1.1% of the open repair patients compared with 0.5% of patients undergoing arthroscopic repairs (P < .0001). -Multivariate logistic regression analysis revealed that the arthroscopic group had a significantly lower risk of complications (P = .0001), a lower rate of superficial infection (P = .0002), a lower incidence of return to the operating room within 30 days (P = .007), and a lower risk of hospital readmission (P < .0001). CONCLUSION: Arthroscopic rotator cuff repair in the veteran population resulted in a lower incidence of perioperative complications compared with open repair. Published by Elsevier Inc.
Authors: Kristin L Buterbaugh; Stephen Y Liu; Aleksandra Krajewski; Glenn A Buterbaugh; Joseph E Imbriglia Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2018-01-11
Authors: Ajay S Padaki; Venkat Boddapati; Justin Mathew; Christopher S Ahmad; Charles M Jobin; William N Levine Journal: JSES Open Access Date: 2019-09-16
Authors: Andrew R Jensen; Peter S Cha; Sai K Devana; Chad Ishmael; Theo Di Pauli von Treuheim; Anthony D'Oro; Jeffrey C Wang; David R McAllister; Frank A Petrigliano Journal: Orthop J Sports Med Date: 2017-10-12