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Trends Associated with Open Versus Arthroscopic Rotator Cuff Repair

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

Rotator cuff (RTC) repair is performed using open/mini-open or arthroscopic procedures, and the use of arthroscopic techniques is increasing. The extent to which surgery has transitioned from open to arthroscopic techniques has yet to be elucidated.

Questions/Purposes

The purpose of this study was to evaluate trends in open and arthroscopic rotator cuff repair in the USA and describe tendencies in treatment across gender, age, and geographic region. We hypothesized that surgeons would be more likely to perform arthroscopic rotator cuff repair, with similar trends across the USA.

Methods

A retrospective review of a comprehensive national insurance database (Humana) was performed using the PearlDiver software for all patients who underwent RTC repair between January 2007 and June 2015. Patients were identified by Current Procedural Terminology (CPT) codes. χ2 tests evaluated the proportion of arthroscopic surgeries by gender and geographic region; logistic regression analysis assessed differences from 2007 to 2015.

Results

In the study period, 54,740 patients underwent RTC repair (68% arthroscopic, 52% male), with the highest frequency of RTC repair in patients between 65 and 69 years old. The proportion of open RTC repair increased with increasing patient age, with no significant difference between men and women. The proportion of arthroscopic RTC surgeries increased from 56.9% in 2007 to 75.1% in 2015. The overall trend was 188% increase in total RTC repairs. Arthroscopic repair was more frequent than open repair in all US regions, with the highest proportion in the South.

Conclusion

Arthroscopic RTC surgery predominates and continues to rise. With increasing patient age, there was an increase in the proportion of open repair. The majority of RTC repairs were performed in patients between 65 and 69 years of age.

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Authors and Affiliations

  1. Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Molly A. Day MD, Robert W. Westermann MD, Nicholas A. Bedard MD, Natalie A. Glass PhD & Brian R. Wolf MD, MS

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  1. Molly A. Day MD
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  2. Robert W. Westermann MD
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  3. Nicholas A. Bedard MD
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  4. Natalie A. Glass PhD
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  5. Brian R. Wolf MD, MS
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Corresponding author

Correspondence to Molly A. Day MD.

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Conflict of Interest

Molly A. Day, MD, Robert W. Westermann, MD, Nicholas A. Bedard, MD, Natalie A. Glass, PhD, declare that they have no conflicts of interest. Brian R. Wolf, MD, MS, reports receiving personal fees from ConMed, Smith & Nephew, and Arthrex, as well as grants from the Orthopaedic Research and Education Foundation, outside the submitted article.

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The study was deemed exempt from IRB approval at our institution.

Additional information

Level of Evidence: Level III, retrospective comparative study

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Day, M.A., Westermann, R.W., Bedard, N.A. et al. Trends Associated with Open Versus Arthroscopic Rotator Cuff Repair. HSS Jrnl 15, 133–136 (2019). https://doi.org/10.1007/s11420-018-9628-2

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  • DOI: https://doi.org/10.1007/s11420-018-9628-2

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