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Published in: European Journal of Trauma and Emergency Surgery 4/2020

01-08-2020 | Arthroscopic Rotator Cuff Repair | Original Article

Return to work after early repair of acute traumatic rotator cuff tears

Authors: Knut E. Aagaard, Patrik Randeblad, Fikri M. Abu-Zidan, Karl Lunsjö

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2020

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Abstract

Background

Lost workdays following rotator cuff repair is not well-studied in the literature. We aimed to define the time away from work following early arthroscopic repair of acute traumatic rotator cuff tears and compare it with the recommendations of the American Medical Disability Advisor (MD Guidelines) and The Swedish Social Insurance Agency.

Methods

Thirty-two consecutive working patients with a median age of 58 (42–70) years suffering from acute traumatic rotator cuff tears who underwent arthroscopic repair were prospectively studied. The studied variables were age, gender, alcohol use, smoking, number of injured tendons, dominant side involvement, work-related injury, employment status, preoperative work level, alterations of work tasks at return to work, and time away from work.

Results

97% of the patients returned to full-duty work. The median time to return to full-duty work was 5.0 (1.1–10.5) months. Preoperative work level (p = 0.025) and dominant side (p = 0.02) significantly affected the time away from work on the univariate analysis, while GLM model showed a trend (p = 0.09) for shorter sick leave by dominant side involvement. The sick leave was longer in all three work level categories compared with the MD Guidelines and longer in the light and medium work categories compared with the recommendations by FK.

Conclusions

According to the present study, acute traumatic rotator cuff tears cause a considerable loss of work days. However, almost all patients are expected to return to work after a median time of 5 months following arthroscopic repair. Current guidelines and recommendations regarding sick leave following repair of rotator cuff tears might have to be reviewed.
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Literature
2.
go back to reference United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), 2nd edn. Rosemont, IL: American Academy of Orthopaedic Surgeons 2008. http://www.boneandjointburden.org. Accessed 20 Nov 2015. United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), 2nd edn. Rosemont, IL: American Academy of Orthopaedic Surgeons 2008. http://​www.​boneandjointburd​en.​org. Accessed 20 Nov 2015.
3.
go back to reference 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(1):116–20.CrossRef 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(1):116–20.CrossRef
4.
go back to reference Mather RC III, Koenig L, Acevedo D, et al. The societal and economic value of rotator cuff repair. J Bone Joint Surg. 2013;95:1993–2000.CrossRef Mather RC III, Koenig L, Acevedo D, et al. The societal and economic value of rotator cuff repair. J Bone Joint Surg. 2013;95:1993–2000.CrossRef
6.
go back to reference Savoie FH 3rd, Field LD, Jenkins RN. Costs analysis of successful rotator cuff repair surgery: an outcome study. Comparison of gatekeeper system in surgical patients. Arthroscopy. 1995;11(6):672–6.CrossRef Savoie FH 3rd, Field LD, Jenkins RN. Costs analysis of successful rotator cuff repair surgery: an outcome study. Comparison of gatekeeper system in surgical patients. Arthroscopy. 1995;11(6):672–6.CrossRef
7.
go back to reference Bhatia S, Piasecki DP, Nho SJ, et al. Early return to work in workers’ compensation patients after arthroscopic full-thickness rotator cuff repair. Arthroscopy. 2010;26(8):1027–34.CrossRef Bhatia S, Piasecki DP, Nho SJ, et al. Early return to work in workers’ compensation patients after arthroscopic full-thickness rotator cuff repair. Arthroscopy. 2010;26(8):1027–34.CrossRef
8.
go back to reference Nové-Josserand L, Liotard JP, Godeneche A, et al. Occupational outcome after surgery in patients with a rotator cuff tear due to a work-related injury or occupational disease. A series of 262 cases. Orthop Traumatol Surg Res. 2011;97(4):361–6.CrossRef Nové-Josserand L, Liotard JP, Godeneche A, et al. Occupational outcome after surgery in patients with a rotator cuff tear due to a work-related injury or occupational disease. A series of 262 cases. Orthop Traumatol Surg Res. 2011;97(4):361–6.CrossRef
9.
go back to reference Shields E, Thirukumaran C, Noyes K, Voloshin I. A review of a workers’ compensation database 2003 to 2013: patient factors influencing return to work and cumulative financial claims after rotator cuff repair in geriatric workers’ compensation cases. Geriatr Orthop Surg Rehabil. 2017;8:208–14.CrossRef Shields E, Thirukumaran C, Noyes K, Voloshin I. A review of a workers’ compensation database 2003 to 2013: patient factors influencing return to work and cumulative financial claims after rotator cuff repair in geriatric workers’ compensation cases. Geriatr Orthop Surg Rehabil. 2017;8:208–14.CrossRef
10.
go back to reference Misamore GW, Ziegler DW, Rushton JL. Repair of the rotator cuff. A comparison of results in two populations of patients. J Bone Joint Surg. 1995;77(9):1335–9.CrossRef Misamore GW, Ziegler DW, Rushton JL. Repair of the rotator cuff. A comparison of results in two populations of patients. J Bone Joint Surg. 1995;77(9):1335–9.CrossRef
11.
go back to reference Collin P, Abdullah A, Kherad O, Gain S, Denard PJ, Ladermann A. Prospective evaluation of clinical and radiologic factors predicting return to activity within 6 months after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2015;24(3):439–45.CrossRef Collin P, Abdullah A, Kherad O, Gain S, Denard PJ, Ladermann A. Prospective evaluation of clinical and radiologic factors predicting return to activity within 6 months after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2015;24(3):439–45.CrossRef
12.
go back to reference Mall NA, Lee AS, Chahal J, et al. An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy. 2013;29(2):366–76.CrossRef Mall NA, Lee AS, Chahal J, et al. An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy. 2013;29(2):366–76.CrossRef
14.
go back to reference Aagaard KE, Hänninen J, Abu-Zidan FM, Lunsjö K. Physical therapists as first-line diagnosticians for traumatic acute rotator cuff tears: a prospective study. Eur J Trauma Emerg Surg. 2018;44(5):735–45.CrossRef Aagaard KE, Hänninen J, Abu-Zidan FM, Lunsjö K. Physical therapists as first-line diagnosticians for traumatic acute rotator cuff tears: a prospective study. Eur J Trauma Emerg Surg. 2018;44(5):735–45.CrossRef
15.
go back to reference Canadian classification and dictionary of occupations 1971. Ottawa: Information Canada; 1974. Canadian classification and dictionary of occupations 1971. Ottawa: Information Canada; 1974.
16.
go back to reference Munro BH. Selected nonparametric techniques. In: Munro BH, editor. Statistical methods for health care research. 4th edn. New York: Lippincott; 2001. pp. 97–121. Munro BH. Selected nonparametric techniques. In: Munro BH, editor. Statistical methods for health care research. 4th edn. New York: Lippincott; 2001. pp. 97–121.
18.
go back to reference Bassett RW, Cofield RH. Acute tears of the rotator cuff. The timing of surgical repair. Clin Orthop Relat Res 1983;(175):18–24. Bassett RW, Cofield RH. Acute tears of the rotator cuff. The timing of surgical repair. Clin Orthop Relat Res 1983;(175):18–24.
19.
go back to reference Bjornsson HC, Norlin R, Johansson K, Adolfsson LE. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop. 2011;82(2):187–92.CrossRef Bjornsson HC, Norlin R, Johansson K, Adolfsson LE. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop. 2011;82(2):187–92.CrossRef
20.
go back to reference Hantes ME, Karidakis GK, Vlychou M, Varitimidis S, Dailiana Z, Malizos KN. A comparison of early versus delayed repair of traumatic rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1766–70.CrossRef Hantes ME, Karidakis GK, Vlychou M, Varitimidis S, Dailiana Z, Malizos KN. A comparison of early versus delayed repair of traumatic rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1766–70.CrossRef
21.
go back to reference Davis AD, Kakar S, Moros C, Kaye EK, Schepsis AA, Voloshin I. Arthroscopic versus open acromioplasty: a meta-analysis. Am J Sports Med. 2010;38(3):613–8.CrossRef Davis AD, Kakar S, Moros C, Kaye EK, Schepsis AA, Voloshin I. Arthroscopic versus open acromioplasty: a meta-analysis. Am J Sports Med. 2010;38(3):613–8.CrossRef
23.
go back to reference Charousset C, Grimberg J, Duranthon LD, Bellaiche L, Petrover D, Kalra K. The time for functional recovery after arthroscopic rotator cuff repair: correlation with tendon healing controlled by computed tomography arthrography. Arthroscopy. 2008;24(1):25–33.CrossRef Charousset C, Grimberg J, Duranthon LD, Bellaiche L, Petrover D, Kalra K. The time for functional recovery after arthroscopic rotator cuff repair: correlation with tendon healing controlled by computed tomography arthrography. Arthroscopy. 2008;24(1):25–33.CrossRef
24.
go back to reference O’Holleran JD, Kocher MS, Horan MP, Briggs KK, Hawkins RJ. Determinants of patient satisfaction with outcome after rotator cuff surgery. J Bone Joint Surg. 2005;87(1):121–6.CrossRef O’Holleran JD, Kocher MS, Horan MP, Briggs KK, Hawkins RJ. Determinants of patient satisfaction with outcome after rotator cuff surgery. J Bone Joint Surg. 2005;87(1):121–6.CrossRef
25.
go back to reference Romeo AA, Hang DW, Bach BR Jr, Scott S. Repair of full thickness rotator cuff tears. Gender, age, and other factors affecting outcome. Clin Orthop Relat Res 1999;(367):243–255. Romeo AA, Hang DW, Bach BR Jr, Scott S. Repair of full thickness rotator cuff tears. Gender, age, and other factors affecting outcome. Clin Orthop Relat Res 1999;(367):243–255.
26.
go back to reference Fermont AJM, Wolterbeek N, Wessel RN, Baeyens J-P, De Bie RA. Prognostic factors for successful recovery after arthroscopic rotator cuff repair: a systematic literature review. J Ortho Sports Phys. 2014;44(3):153–63.CrossRef Fermont AJM, Wolterbeek N, Wessel RN, Baeyens J-P, De Bie RA. Prognostic factors for successful recovery after arthroscopic rotator cuff repair: a systematic literature review. J Ortho Sports Phys. 2014;44(3):153–63.CrossRef
27.
go back to reference Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009;25:30–9.CrossRef Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009;25:30–9.CrossRef
28.
go back to reference Razmjou H, Davis AM, Jaglal SB, Holtby R, Richards RR. Disability and satisfaction after rotator cuff decompression or repair: a sex and gender analysis. BMC Musculoskel Dis. 2011;12:66–6.CrossRef Razmjou H, Davis AM, Jaglal SB, Holtby R, Richards RR. Disability and satisfaction after rotator cuff decompression or repair: a sex and gender analysis. BMC Musculoskel Dis. 2011;12:66–6.CrossRef
29.
go back to reference Inderhaug E, Kollevold KH, Kalsvik M, Hegna J, Solheim E. Preoperative NSAIDs, non-acute onset and long-standing symptoms predict inferior outcome at long-term follow-up after rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2067–72.CrossRef Inderhaug E, Kollevold KH, Kalsvik M, Hegna J, Solheim E. Preoperative NSAIDs, non-acute onset and long-standing symptoms predict inferior outcome at long-term follow-up after rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2067–72.CrossRef
30.
go back to reference Kolk A, Wolterbeek N, Auw Yang KG, Zijl JA, Wessel RN. Predictors of disease-specific quality of life after arthroscopic rotator cuff repair. Int Orthop. 2016;40(2):323–9.CrossRef Kolk A, Wolterbeek N, Auw Yang KG, Zijl JA, Wessel RN. Predictors of disease-specific quality of life after arthroscopic rotator cuff repair. Int Orthop. 2016;40(2):323–9.CrossRef
31.
go back to reference Cho CH, Ye HU, Jung JW, Lee YK. Gender affects early postoperative outcomes of rotator cuff repair. Clin Orthop Surg. 2015;7(2):234–40.CrossRef Cho CH, Ye HU, Jung JW, Lee YK. Gender affects early postoperative outcomes of rotator cuff repair. Clin Orthop Surg. 2015;7(2):234–40.CrossRef
32.
go back to reference Choi S, Kim MK, Kim GM, Roh Y-H, Hwang IK, Kang H. Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears. J Shoulder Elbow Surg. 2014;23:1675–81.CrossRef Choi S, Kim MK, Kim GM, Roh Y-H, Hwang IK, Kang H. Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears. J Shoulder Elbow Surg. 2014;23:1675–81.CrossRef
33.
go back to reference Gulotta LV, Nho SJ, Dodson CC, Adler RS, Altchek DW, MacGillivray JD. Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II–prognostic factors for clinical and radiographic outcomes. J Shoulder Elbow Surg. 2011;20:941–6.CrossRef Gulotta LV, Nho SJ, Dodson CC, Adler RS, Altchek DW, MacGillivray JD. Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II–prognostic factors for clinical and radiographic outcomes. J Shoulder Elbow Surg. 2011;20:941–6.CrossRef
34.
go back to reference Razmjou H, Lincoln S, Boljanovic D, Gallay S, Henry P, Richards RR, Holtby R. The effect of expedited rotator cuff surgery in injured workers: a case-control study. J Shoulder Elbow Surg. 2017;26:1196–202.CrossRef Razmjou H, Lincoln S, Boljanovic D, Gallay S, Henry P, Richards RR, Holtby R. The effect of expedited rotator cuff surgery in injured workers: a case-control study. J Shoulder Elbow Surg. 2017;26:1196–202.CrossRef
Metadata
Title
Return to work after early repair of acute traumatic rotator cuff tears
Authors
Knut E. Aagaard
Patrik Randeblad
Fikri M. Abu-Zidan
Karl Lunsjö
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2020
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01074-9

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