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National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis.
Orthopedics. 2020 Jun 30 [Online ahead of print]O

Abstract

Both rotator cuff repair (RCR) and reverse total shoulder arthroplasty (RTSA) are effective treatment options for chronic large degenerative rotator cuff tear (RCT) in the elderly. The goal of this study was to evaluate national trends for surgical management of chronic RCT among patients without glenohumeral arthritis. The authors conducted a retrospective review from 2007 to 2015 using the PearlDiver database. The study included patients who had the International Classification of Diseases, Ninth Revision, diagnosis of chronic RCT without shoulder arthritis. Procedural codes from the Current Procedural Terminology and the International Classification of Diseases, Ninth Revision, were used to identify patients undergoing RCR or RTSA. Chi-square analysis assessed differences between the groups, and Cochran-Armitage trend tests were used to evaluate trends over time. Overall, 428,651 patients had chronic RCT without arthritis; 364,141 (84.9%) were treated nonoperatively, 53,566 (12.5%) underwent RCR, and 10,944 (2.6%) underwent RTSA. Patients who were 60 to 79 years old had the highest rate of surgical intervention (70.8% of all surgical patients), with 69.2% and 78.4% who underwent RCR and RTSA, respectively. A 3-fold increase in RTSA use was noted among patients 60 years and older vs patients younger than 60 years. Overall revision rates 2 years after RCR and RTSA among patients 60 to 79 years old were 13.0% and 3.7%, respectively. Revision rates after RCR remained constant over time (9.3% to 13.0%; P=.082), whereas revision rates after RTSA decreased significantly over time (12.1% to 2.2%; P=.016). Older patients were more likely to be treated nonoperatively compared with younger patients, but among those patients treated with RTSA, there was a 3-fold increase in the use of RTSA in patients older than 60 years compared with patients younger than 60 years. Further, the authors found that revision rates after RTSA decreased over time (from 12% to 2%), suggesting better implant design, improved knowledge of implant positioning, and increased surgical proficiency. [Orthopedics. 2020;43(x):xx-xx.].

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32602925

Citation

Vora, Molly, et al. "National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis." Orthopedics, 2020, pp. 1-6.
Vora M, Sing DC, Curry EJ, et al. National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis. Orthopedics. 2020.
Vora, M., Sing, D. C., Curry, E. J., Kamal, R. N., & Li, X. (2020). National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis. Orthopedics, 1-6. https://doi.org/10.3928/01477447-20200619-09
Vora M, et al. National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis. Orthopedics. 2020 Jun 30;1-6. PubMed PMID: 32602925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis. AU - Vora,Molly, AU - Sing,David C, AU - Curry,Emily J, AU - Kamal,Robin N, AU - Li,Xinning, Y1 - 2020/06/30/ PY - 2019/01/23/received PY - 2019/06/28/accepted PY - 2020/7/1/entrez SP - 1 EP - 6 JF - Orthopedics JO - Orthopedics N2 - Both rotator cuff repair (RCR) and reverse total shoulder arthroplasty (RTSA) are effective treatment options for chronic large degenerative rotator cuff tear (RCT) in the elderly. The goal of this study was to evaluate national trends for surgical management of chronic RCT among patients without glenohumeral arthritis. The authors conducted a retrospective review from 2007 to 2015 using the PearlDiver database. The study included patients who had the International Classification of Diseases, Ninth Revision, diagnosis of chronic RCT without shoulder arthritis. Procedural codes from the Current Procedural Terminology and the International Classification of Diseases, Ninth Revision, were used to identify patients undergoing RCR or RTSA. Chi-square analysis assessed differences between the groups, and Cochran-Armitage trend tests were used to evaluate trends over time. Overall, 428,651 patients had chronic RCT without arthritis; 364,141 (84.9%) were treated nonoperatively, 53,566 (12.5%) underwent RCR, and 10,944 (2.6%) underwent RTSA. Patients who were 60 to 79 years old had the highest rate of surgical intervention (70.8% of all surgical patients), with 69.2% and 78.4% who underwent RCR and RTSA, respectively. A 3-fold increase in RTSA use was noted among patients 60 years and older vs patients younger than 60 years. Overall revision rates 2 years after RCR and RTSA among patients 60 to 79 years old were 13.0% and 3.7%, respectively. Revision rates after RCR remained constant over time (9.3% to 13.0%; P=.082), whereas revision rates after RTSA decreased significantly over time (12.1% to 2.2%; P=.016). Older patients were more likely to be treated nonoperatively compared with younger patients, but among those patients treated with RTSA, there was a 3-fold increase in the use of RTSA in patients older than 60 years compared with patients younger than 60 years. Further, the authors found that revision rates after RTSA decreased over time (from 12% to 2%), suggesting better implant design, improved knowledge of implant positioning, and increased surgical proficiency. [Orthopedics. 2020;43(x):xx-xx.]. SN - 1938-2367 UR - https://www.unboundmedicine.com/medline/citation/32602925/National_Trends_in_the_Surgical_Treatment_of_Chronic_Rotator_Cuff_Tear_in_Patients_Without_Arthritis L2 - https://www.healio.com/doiresolver?doi=10.3928/01477447-20200619-09 DB - PRIME DP - Unbound Medicine ER -
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