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. 2017 May 22;5(5):2325967117705319.
doi: 10.1177/2325967117705319. eCollection 2017 May.

Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery

Helen Razmjou  1 , Dragana Boljanovic  1 , Sandra Lincoln  1 , Richard Holtby  1 , Stephen Gallay  1 , Patrick Henry  1 , Iona Macritchie  1 ; WCP Consortium; Cheryl Borthwick  1 , Lauren Mayer  1 , Carolyn Roknic  1 , Deborah Shore  1 , Allison Kamino  1 , Julie Grossman  1 , Joanne Hill  1 , Gargi Singh  1 , Niki Travers  1 , Loraine Yanofsky  1 , Marni Wilson  1 , Shellina Sumar  1 , Alicia Savona  1 , Filomena De Medeiros  1 , Helen Mann  1 , Aisha Champsi  1 , Stefanie Chau  1 , Danielle Medeiros  1 , Robin R Richards  1
Affiliations

Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery

Helen Razmjou et al. Orthop J Sports Med. .

Abstract

Background: Work-related rotator cuff injuries are a common cause of disability and employee time loss.

Purpose: To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery.

Study design: Case series; Level of evidence, 4.

Methods: Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status.

Results: One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) (P < .0001). Eighty-four percent (n = 122) of patients exceeded the MCID of 17 points. Individual factors that affected patient overall disability were preoperative ASES, work status prior to surgery, access to care, and autonomy at work. Achieving a minimal clinically meaningful change was influenced by perceived access to care, autonomy and stress at work, and overall satisfaction with the job.

Conclusion: Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.

Keywords: expedited surgery; rotator cuff; workers’ compensation.

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Conflict of interest statement

The authors declared that they have no potential conflicts of interest in the authorship and publication of this contribution.

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