Saturday, June 22, 2024

Impact of Preoperative Characteristics on Post-Arthroscopic Rotator Cuff Repair Outcomes

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In the quest to optimize patient outcomes following primary arthroscopic rotator cuff repair, understanding the influence of preoperative characteristics is critical. This study delves into how factors like smoking, opioid and alcohol use, obesity, mood disorders, disability claims, and Workers’ Compensation status impact postoperative pain and function. By analyzing these variables, the research aims to identify modifiable risk factors that could be addressed before surgery to enhance recovery and overall patient satisfaction.

Study Overview

A total of seventy-five patients undergoing primary arthroscopic rotator cuff repairs were followed for a minimum of two years. The variables under scrutiny included preoperative tobacco, opioid, and alcohol consumption; obesity; mood disorders; disability claims; and Workers’ Compensation status. The outcome measures assessed were visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength.

Key Findings

The study revealed that preoperative smoking significantly correlated with worse outcomes in terms of pain (p = 0.009), ASES (p = 0.004), and SANE (p = 0.011) scores. Conversely, opioid use did not show a statistically significant impact on pain or functional scores. Interestingly, alcohol use was associated with improved ASES scores in the long term (p = 0.046). Other factors, such as obesity, mood disorders, disability claims, and Workers’ Compensation status, did not demonstrate a significant effect on the postoperative outcomes.

Inferences for Clinical Practice

  • Preoperative smoking cessation could significantly improve postoperative pain and functional outcomes.
  • Preoperative opioid use does not necessarily predict worse pain or functional scores post-surgery, suggesting other contributing factors need to be considered.
  • Moderate alcohol consumption may be linked to better long-term functional outcomes post-surgery.
  • Screening for modifiable risk factors pre-surgery can aid in personalized patient care and optimized recovery plans.

These findings underscore the importance of addressing modifiable risk factors such as smoking and potentially leveraging factors like moderate alcohol use to enhance postoperative outcomes for patients undergoing arthroscopic rotator cuff repair. Further research could continue to explore and validate these associations, paving the way for improved preoperative patient education and intervention strategies.

Original Article: J Surg Orthop Adv. 2024 Spring;33(1):5-9. PMID: 38815070

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