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Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile?
Arthroscopy. 2017 Oct; 33(10):1764-1769.A

Abstract

PURPOSE

To provide a comparative 30-day postoperative analysis of complications and unplanned readmission rates, using the National Surgical Quality Improvement Program database, after open or arthroscopic rotator cuff repair (RCR).

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database was reviewed for postoperative complications after open or arthroscopic RCR over an 8-year period, from 2007 through 2014. Patients were identified by use of Current Procedural Terminology codes. The open group contained 3,590 cases (21.8%) and the arthroscopic group had 12,882 cases (78.2%), for a total of 16,472 patients undergoing RCR. The risk of complications was compared between the 2 groups, along with patient demographic characteristics, operative time, length of stay, and unplanned readmission within 30 days. We compared dichotomous variables using the Fisher exact test and continuous variables with 1-way analysis of variance. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated when appropriate.

RESULTS

The open RCR group had a higher prevalence of patients aged 65 years or older and comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, smoking, and alcoholism (P < .05). Patients undergoing open RCR had a higher risk of any adverse event when compared with arthroscopic RCR patients (1.48% vs 0.84%; RR, 1.17; 95% CI, 1.05-1.30; P = .0010). They were also at higher risk of return to the operating room within 30 days (0.70% vs 0.26%; RR, 1.36; 95% CI, 1.09-1.69; P = .0004). Open RCR was associated with a longer average hospital stay (0.48 ± 2.7 days vs 0.23 ± 4.2 days, P = .0007), whereas arthroscopic RCR had a longer average operative time (90 ± 45 minutes vs 79 ± 45 minutes, P < .0001).

CONCLUSIONS

Although both open and arthroscopic approaches to RCR had low morbidity, arthroscopy was associated with lower risks of any adverse event and return to the operating room during the initial 30-day postoperative period.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

Authors+Show Affiliations

University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.. Electronic address: bponce@uabmc.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28688827

Citation

Baker, Dustin K., et al. "Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile?" Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 33, no. 10, 2017, pp. 1764-1769.
Baker DK, Perez JL, Watson SL, et al. Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile? Arthroscopy. 2017;33(10):1764-1769.
Baker, D. K., Perez, J. L., Watson, S. L., McGwin, G., Brabston, E. W., Hudson, P. W., & Ponce, B. A. (2017). Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile? Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 33(10), 1764-1769. https://doi.org/10.1016/j.arthro.2017.04.019
Baker DK, et al. Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile. Arthroscopy. 2017;33(10):1764-1769. PubMed PMID: 28688827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic Versus Open Rotator Cuff Repair: Which Has a Better Complication and 30-Day Readmission Profile? AU - Baker,Dustin K, AU - Perez,Jorge L, AU - Watson,Shawna L, AU - McGwin,Gerald, AU - Brabston,Eugene W, AU - Hudson,Parke W, AU - Ponce,Brent A, Y1 - 2017/07/05/ PY - 2016/12/01/received PY - 2017/04/03/revised PY - 2017/04/12/accepted PY - 2017/7/10/pubmed PY - 2018/5/8/medline PY - 2017/7/10/entrez SP - 1764 EP - 1769 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 33 IS - 10 N2 - PURPOSE: To provide a comparative 30-day postoperative analysis of complications and unplanned readmission rates, using the National Surgical Quality Improvement Program database, after open or arthroscopic rotator cuff repair (RCR). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was reviewed for postoperative complications after open or arthroscopic RCR over an 8-year period, from 2007 through 2014. Patients were identified by use of Current Procedural Terminology codes. The open group contained 3,590 cases (21.8%) and the arthroscopic group had 12,882 cases (78.2%), for a total of 16,472 patients undergoing RCR. The risk of complications was compared between the 2 groups, along with patient demographic characteristics, operative time, length of stay, and unplanned readmission within 30 days. We compared dichotomous variables using the Fisher exact test and continuous variables with 1-way analysis of variance. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated when appropriate. RESULTS: The open RCR group had a higher prevalence of patients aged 65 years or older and comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, smoking, and alcoholism (P < .05). Patients undergoing open RCR had a higher risk of any adverse event when compared with arthroscopic RCR patients (1.48% vs 0.84%; RR, 1.17; 95% CI, 1.05-1.30; P = .0010). They were also at higher risk of return to the operating room within 30 days (0.70% vs 0.26%; RR, 1.36; 95% CI, 1.09-1.69; P = .0004). Open RCR was associated with a longer average hospital stay (0.48 ± 2.7 days vs 0.23 ± 4.2 days, P = .0007), whereas arthroscopic RCR had a longer average operative time (90 ± 45 minutes vs 79 ± 45 minutes, P < .0001). CONCLUSIONS: Although both open and arthroscopic approaches to RCR had low morbidity, arthroscopy was associated with lower risks of any adverse event and return to the operating room during the initial 30-day postoperative period. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/28688827/Arthroscopic_Versus_Open_Rotator_Cuff_Repair:_Which_Has_a_Better_Complication_and_30_Day_Readmission_Profile L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(17)30391-2 DB - PRIME DP - Unbound Medicine ER -