Advertisement

Arthroscopic and Open or Mini-Open Rotator Cuff Repair Trends and Complication Rates Among American Board of Orthopaedic Surgeons Part II Examinees (2007-2017)

      Purpose

      To ascertain trends and reported complication rates of arthroscopic and open or mini-open rotator cuff repairs (RCRs) reported by American Board of Orthopaedic Surgery (ABOS) Part II examinees between 2007-2017.

      Methods

      The ABOS database was queried for both arthroscopic RCR (International Classification of Diseases code 29827) and open or mini-open RCR (International Classification of Diseases codes 23410 and 23412) performed by Part II examinees from 2007-2017. A comparison between overall procedure rates, as well as reported complications (anesthetic, medical, surgical, reoperations, and readmissions) associated with the respective repair technique, was performed.

      Results

      From 2007-2017, a total of 31,907 RCRs were reported by Part II examinees. Of those, 85.2% (n = 27,189) were arthroscopic whereas 14.8% (n = 4,718) were open or mini-open. The rate of arthroscopic RCR increased from 73% (n = 2,138) in 2007 to 90% (n = 2,031) in 2017, whereas the rate of open or mini-open RCR decreased from 27% (n = 771) to 10% (n = 234) during the same period. Rates of reported annual complications were significantly lower for arthroscopic RCR (7.4%-16.2%) than for open or mini-open RCR (12.9%-30.3%) for each of the past 6 years (2012-2017) (P < .001). Arthroscopic RCR had an overall lower cumulative occurrence of complications than open or mini-open RCR over the past decade (2007-2017) (P < .001). The relative risk of complications for arthroscopic RCR compared with open RCR was 0.71 (95% confidence interval, 0.66-0.77).

      Conclusions

      ABOS Part II examinees reported an increased practice of arthroscopic RCR in comparison with open or mini-open RCR over the past 10 years. Reported annual complication rates have been significantly lower for arthroscopic RCR over the past 6 years, with an overall lower cumulative rate from 2007-2017.

      Level of Evidence

      Level III, retrospective cohort study.
      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

        • Williams G.
        • Kraeutler M.J.
        • Zmistowski B.
        • Fenlin J.M.
        No difference in postoperative pain after arthroscopic versus open rotator cuff repair.
        Clin Orthop Relat Res. 2014; 472: 2759-2765
        • Mohtadi N.G.
        • Hollinshead R.M.
        • Sasyniuk T.M.
        • Fletcher J.A.
        • Chan D.S.
        • Li F.X.
        A randomized clinical trial comparing open to arthroscopic acromioplasty with mini-open rotator cuff repair for full-thickness rotator cuff tears: Disease-specific quality of life outcome at an average 2-year follow-up.
        Am J Sports Med. 2008; 36: 1043-1051
        • Huang R.
        • Wang S.
        • Wang Y.
        • Qin X.
        • Sun Y.
        Systematic review of all-arthroscopic versus mini-open repair of rotator cuff tears: A meta-analysis.
        Sci Rep. 2016; 6: 22857
        • Yamaguchi K.
        • Levine W.N.
        • Marra G.
        • Galatz L.M.
        • Klepps S.
        • Flatow E.L.
        Transitioning to arthroscopic rotator cuff repair: The pros and cons.
        Instr Course Lect. 2003; 52: 81-92
        • Dunn W.R.
        • Schackman B.R.
        • Walsh C.
        • et al.
        Variation in orthopaedic surgeonsʼ perceptions about the indications for rotator cuff surgery.
        J Bone Joint Surg Am. 2005; 87: 1978-1984
        • Morse K.
        • Davis A.D.
        • Afra R.
        • Kaye E.K.
        • Schepsis A.
        • Voloshin I.
        Arthroscopic versus mini-open rotator cuff repair: A comprehensive review and meta-analysis.
        Am J Sports Med. 2008; 36: 1824-1828
        • Colvin A.C.
        • Egorova N.
        • Harrison A.K.
        • Moskowitz A.
        • Flatow E.L.
        National trends in rotator cuff repair.
        J Bone Joint Surg Am. 2012; 94: 227-233
        • 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
        • Jensen A.R.
        • Cha P.S.
        • Devana S.K.
        • et al.
        Evaluation of the trends, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in the Medicare population.
        Orthop J Sports Med. 2017; 5 (2325967117731310)
        • Kang L.
        • Henn F.
        • Tashjian R.
        • Green A.
        Early outcome of arthroscopic rotator cuff repair: A matched comparison with mini-open rotator cuff repair.
        Arthroscopy. 2007; 23: 573-582.e2
        • Buess E.
        • Steuber K.-U.
        • Waibl B.
        Open versus arthroscopic rotator cuff repair: A comparative view of 96 cases.
        Arthroscopy. 2005; 21: 597-604
        • Kasten P.
        • Keil C.
        • Grieser T.
        • Raiss P.
        • Streich N.
        • Loew M.
        Prospective randomised comparison of arthroscopic versus mini-open rotator cuff repair of the supraspinatus tendon.
        Int Orthop. 2011; 35: 1663-1670
        • Bayle X.
        • Pham T.-T.
        • Faruch M.
        • Gobet A.
        • Mansat P.
        • Bonnevialle N.
        No difference in outcome for open versus arthroscopic rotator cuff repair: A prospective comparative trial.
        Arch Orthop Trauma Surg. 2017; 137: 1707-1712
        • Bishop J.
        • Klepps S.
        • Lo I.
        • Bird J.
        • Gladstone J.
        • Flatow E.L.
        Cuff integrity after arthroscopic versus open rotator cuff repair: A prospective study.
        J Shoulder Elbow Surg. 2006; 15: 290-299
        • Liu J.
        • Fan L.
        • Zhu Y.
        • Yu H.
        • Xu T.
        • Li G.
        Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears: A randomized clinical trial.
        Medicine (Baltimore). 2017; 96: e6322
        • Desai S.S.
        • Mata H.K.
        Long head of biceps tendon pathology and results of tenotomy in full-thickness reparable rotator cuff tear.
        Arthroscopy. 2017; 33: 1971-1976