Advertisement

Risk Factors for Short-term Complications After Rotator Cuff Repair in the United States

Published:December 12, 2017DOI:https://doi.org/10.1016/j.arthro.2017.10.040

      Purpose

      To use a population-level dataset to evaluate the rate of 30-day complications after rotator cuff repair, and to evaluate the risk factors for complication and unplanned hospital readmission.

      Methods

      We used the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2015 to identify patients who underwent rotator cuff repair and concomitant procedures using Current Procedural Terminology codes. Postoperative complications and unplanned hospital readmissions were identified. Patient demographics, medical comorbidities, and perioperative variables were used in a multivariate logistic regression model to identify the risk factors for infection, any complication, and unplanned hospital readmission.

      Results

      A total of 23,741 patients were identified who underwent rotator cuff repair. Overall, 1.39% of patients experienced at least 1 complication, with 0.66% minor complications and 0.85% major complications. Unplanned readmission occurred in 1.16% of patients. Infection was the most common complication, occurring in 0.3% of patients (n = 72), and was the most common reason for return to the operating room. Open rotator cuff repair and male gender were independent risk factors for all outcomes. Increased age and numerous medical comorbidities were associated with the risk of any complication or unplanned hospital readmission.

      Conclusions

      Rotator cuff repair has a low incidence of short-term complications. Infection was the most common complication. Open repair, male gender, increased age, and medical comorbidities all significantly increased the risk of complications and hospital readmission.

      Level of Evidence

      Level IV, case series.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Yamamoto A.
        • Takagishi K.
        • Osawa T.
        • et al.
        Prevalence and risk factors of a rotator cuff tear in the general population.
        J Shoulder Elbow Surg. 2010; 19: 116-120
        • Moosmayer S.
        • Tariq R.
        • Stiris M.
        • Smith H.J.
        The natural history of asymptomatic rotator cuff tears: A three-year follow-up of fifty cases.
        J Bone Joint Surg Am. 2013; 95: 1249-1255
        • Keener J.D.
        • Galatz L.M.
        • Teefey S.A.
        • et al.
        A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears.
        J Bone Joint Surg Am. 2015; 97: 89-98
        • Jeon Y.
        • Kim R.
        • Shin S.
        What influence does progression of a nonhealing rotator cuff tear have on shoulder pain and function?.
        Clin Orthop Relat Res. 2017; 475: 1596-1604
        • Iyengar J.J.
        • Samagh S.P.
        • Schairer W.
        • Singh G.
        • Valone III, F.H.
        • Feeley B.T.
        Current trends in rotator cuff repair: Surgical technique, setting, and cost.
        Arthroscopy. 2014; 30: 284-288
        • Paloneva J.
        • Lepola V.
        • Aarimaa V.
        • Joukainen A.
        • Ylinen J.
        • Mattila V.M.
        Increasing incidence of rotator cuff repairs—A nationwide registry study in Finland.
        BMC Musculoskelet Disord. 2015; 16: 189
        • Park M.C.
        • Tibone J.E.
        • ElAttrache N.S.
        • Ahmad C.S.
        • Jun B.J.
        • Lee T.Q.
        Part II: Biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique.
        J Shoulder Elbow Surg. 2007; 16: 469-476
        • Saltzman B.M.
        • Jain A.
        • Campbell K.A.
        • et al.
        Does the use of platelet-rich plasma at the time of surgery improve clinical outcomes in arthroscopic rotator cuff repair when compared with control cohorts? A systematic review of meta-analyses.
        Arthroscopy. 2016; 32: 906-918
        • Lewington M.R.
        • Ferguson D.P.
        • Smith T.D.
        • Burks R.
        • Coady C.
        • Wong I.H.
        Graft utilization in the bridging reconstruction of irreparable rotator cuff tears: A systematic review.
        Am J Sports Med. 2017; 45: 3149-3157
        • Ono Y.
        • Davalos Herrera D.A.
        • Woodmass J.M.
        • Boorman R.S.
        • Thornton G.M.
        • Lo I.K.
        Graft augmentation versus bridging for large to massive rotator cuff tears: A systematic review.
        Arthroscopy. 2017; 33: 673-680
        • Yoon J.P.
        • Chung S.W.
        • Kim J.Y.
        • et al.
        Outcomes of combined bone marrow stimulation and patch augmentation for massive rotator cuff tears.
        Am J Sports Med. 2016; 44: 963-971
        • Owens B.D.
        • Williams A.E.
        • Wolf J.M.
        Risk factors for surgical complications in rotator cuff repair in a veteran population.
        J Shoulder Elbow Surg. 2015; 24: 1707-1712
        • American College of Surgeons
        User Guide for the 2015 ACS NSQIP Particupant Use File (PUF).
        2016
        • Brislin K.J.
        • Field L.D.
        • Savoie III, F.H.
        Complications after arthroscopic rotator cuff repair.
        Arthroscopy. 2007; 23: 124-128
        • Shields E.
        • Iannuzzi J.C.
        • Thorsness R.
        • Noyes K.
        • Voloshin I.
        Postoperative morbidity by procedure and patient factors influencing major complications within 30 days following shoulder surgery.
        Orthop J Sports Med. 2014; 2 (2325967114553164)
        • Sing D.C.
        • Ding D.Y.
        • Aguilar T.U.
        • et al.
        The effects of patient obesity on early postoperative complications after shoulder arthroscopy.
        Arthroscopy. 2016; 32: 2212-2217.e2211
        • Rubenstein W.J.
        • Pean C.A.
        • Colvin A.C.
        Shoulder arthroscopy in adults 60 or older: Risk factors that correlate with postoperative complications in the first 30 days.
        Arthroscopy. 2017; 33: 49-54
        • Kluczynski M.A.
        • Bisson L.J.
        • Marzo J.M.
        Does body mass index affect outcomes of ambulatory knee and shoulder surgery?.
        Arthroscopy. 2014; 30: 856-865
        • Hill J.R.
        • McKnight B.
        • Pannell W.C.
        • et al.
        Risk factors for 30-day readmission following shoulder arthroscopy.
        Arthroscopy. 2017; 33: 55-61
        • Baker D.K.
        • Perez J.L.
        • Watson S.L.
        • et al.
        Arthroscopic versus open rotator cuff repair: Which has a better complication and 30-day readmission profile?.
        Arthroscopy. 2017; 33: 1764-1769
        • Vopat B.G.
        • Lee B.J.
        • DeStefano S.
        • et al.
        Risk factors for infection after rotator cuff repair.
        Arthroscopy. 2016; 32: 428-434
        • Nho S.J.
        • Shindle M.K.
        • Sherman S.L.
        • Freedman K.B.
        • Lyman S.
        • MacGillivray J.D.
        Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair.
        J Bone Joint Surg Am. 2007; 89: 127-136
        • Moen T.C.
        • Rudolph G.H.
        • Caswell K.
        • Espinoza C.
        • Burkhead Jr., W.Z.
        • Krishnan S.G.
        Complications of shoulder arthroscopy.
        J Am Acad Orthop Surg. 2014; 22: 410-419
        • Koh J.L.
        • Levin S.D.
        • Chehab E.L.
        • Murphy G.S.
        Neer Award 2012: Cerebral oxygenation in the beach chair position: A prospective study on the effect of general anesthesia compared with regional anesthesia and sedation.
        J Shoulder Elbow Surg. 2013; 22: 1325-1331
        • Lansky D.
        • Nwachukwu B.U.
        • Bozic K.J.
        Using financial incentives to improve value in orthopaedics.
        Clin Orthop Relat Res. 2012; 470: 1027-1037