International Orthopaedics

, Volume 33, Issue 2, pp 315–320 | Cite as

Difference in outcome of shoulder surgery between workers’ compensation and nonworkers’ compensation populations

  • Paul KoljonenEmail author
  • Calvin Chong
  • Daniel Yip
Review Article


The purpose of this study was to review the association between compensation status and surgical outcome especially of the shoulder. Given the high prevalence of shoulder injuries in the workplace and the large proportion of workers compensation (WC) claims involving such injuries, it is worth examining the correlation between WC status and surgical outcome of the shoulder. All studies published in journals (MEDLINE and PubMed) from 1980 through 2007 on surgical interventions performed on the shoulder in which workers compensation status was documented and the postoperative functional outcome was compared according to that status were pooled for meta-analysis. This systematic review shows that compensation status of an individual receiving shoulder surgery is a consistent positive predictor of poor functional outcome. The majority of questions posed in the most commonly adopted shoulder-specific functional outcome measurement tools were subjective in nature and may account for part of the phenomenon.


Rotator Cuff Rotator Cuff Repair Compensation Status Shoulder Injury Simple Shoulder Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Analyser l’effet du statut d’accident du travail sur les résultats de la chirurgie au niveau de l’épaule. Etant donnée la fréquence élevée des traumatismes de l’épaule sur le lieu de travail et la part importante de demandes d’indemnisation chez les travailleurs avec ce type de blessures, il est intéressant d’étudier la corrélation entre le statut accident du travail et les résultats de la chirurgie de l’épaule. Toutes les études publiées dans les journaux médicaux (MEDLINE et PUBMED) de 1980 à 2007 concernant des interventions réalisées au niveau de l’épaule dans lesquelles le statut accident du travail était documenté et le résultat post opératoire étudié en fonction de ce statut ont été réunis pour une méta analyse. Cette revue systématique montre que le statut accident du travail d’un individu opéré de l’épaule est un facteur prédictif d’un mauvais résultat. La majorité des questions posées dans les tests spécifiques de l’épaule les plus couramment utilisés sont de nature subjective et cela pourrait expliquer en partie ce phénomène.


  1. 1.
    Abboud JA, Silverberg D, Pepe M, Beredjiklian PK, Iannotti JP, Williams GR et al (2006) Surgical treatment of os acromiale with and without associated rotator cuff tears. J Shoulder Elbow Surg 15(3):265–270PubMedCrossRefGoogle Scholar
  2. 2.
    Antoniou J, Duckworth DT, Harryman DT II (2007) Capsulolabral augmentation for the management of posteroinferior instability of the shoulder. J Bone Jt Surg Am 82-A(9):1220–1230Google Scholar
  3. 3.
    Arcand MA, O’Rourke P, Zeman CA, Burkhead WZ Jr (2000) Revision surgery after failed subacromial decompression. Int Orthop 24:61–64PubMedCrossRefGoogle Scholar
  4. 4.
    Bernard BP (1997) Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back. National Institute for Occupational Safety and Health, Center for Disease Control and Prevention, Atlanta, GA, USAGoogle Scholar
  5. 5.
    Buckle PW, Devereux JJ (2002) The nature of work-related neck and upper limb musculoskeletal disorders. Appl Ergon 33:207–217PubMedCrossRefGoogle Scholar
  6. 6.
    Budoff JE, Rodin D, Ochiai D, Nirschl RP (2005) Arthroscopic rotator cuff debridement without decompression for the treatment of tendinosis. Arthroscopy 21(9):1081–1089PubMedCrossRefGoogle Scholar
  7. 7.
    Callaham ML, Wears RL, Weber EJ, Barton C, Young G (1998) Positive-outcome bias and other limitations in the outcome of research abstracts submitted to a scientific meeting. JAMA 280(3):254–257PubMedCrossRefGoogle Scholar
  8. 8.
    Chen AL, Bain EB, Horan MP, Hawkins RJ (2007) Determinants of patient satisfaction with outcome after shoulder arthroplasty. J Shoulder Elbow Surg 16(1):25–30PubMedCrossRefGoogle Scholar
  9. 9.
    Connor PM, Yamaguchi K, Pollock RG (2000) Comparison of arthroscopic and open revision decompression for failed anterior acromoplasty. Orthopedics 23(6):549–554PubMedGoogle Scholar
  10. 10.
    Ellman H, Kay SP (1991) Arthroscopic subacromial decompression for chronic impingement. J Bone Jt Surg Br 73-B(3):395–398Google Scholar
  11. 11.
    Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS (1999) Chronic pain disability exaggeration/malingering and submaximal effort research. Clin J Pain 15(4):244–274CrossRefGoogle Scholar
  12. 12.
    Frieman BG, Fenlin JM (1995) Anterior acromioplasty: effect of litigation and workers’ compensation. J Shoulder Elbow Surg 4(3):175–181PubMedCrossRefGoogle Scholar
  13. 13.
    Frost P, Bonde JPE, Mikkelsen S, Andersen JH, Fallentin N, Kaergaard A et al (2002) Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work. Am J Ind Med 41:11–18PubMedCrossRefGoogle Scholar
  14. 14.
    Gartsman GM (1990) Arthroscopic acromioplasty for lesions of the rotator cuff. J Bone Jt Surg 72(2):169–180Google Scholar
  15. 15.
    Harris I, Mulford J, Solomon M, vanGelder JM, Young J (2005) Association between compensation status and outcome after surgery. JAMA 293(13):1644–1652PubMedCrossRefGoogle Scholar
  16. 16.
    Hawkins RJ, Brock RM, Abrams JS, Hobeika P (1988) Acromioplasty for impingement with an intact rotator cuff. J Bone Jt Surg 70-B(5):795–797Google Scholar
  17. 17.
    Hawkins RJ, Chris T, Bokor D, Kiefer G (1989) Failed anterior acromioplasty: a review of 51 cases. Clin Orthop Relat Res 243:106–111PubMedGoogle Scholar
  18. 18.
    Hawkins RJ, Morin WD, Bonutti PM (1999) Surgical treatment of full-thickness rotator cuff tears in patients 20 years of age or younger. J Shoulder Elbow Surg 8(3):259–265PubMedCrossRefGoogle Scholar
  19. 19.
    Hawkins RJ, Plancher KD, Saddemi SR, Brezenoff LS, Moor JT (2001) Arthroscopic subacromial decompression. J Shoulder Elbow Surg 10(3):225–230PubMedCrossRefGoogle Scholar
  20. 20.
    Iannotti JP, Bernot MP, Kuhlman JR, Kelley MJ, Williams GR (1996) Postoperative assessment of shoulder function: a prospective study of full-thickness rotator cuff tears. J Shoulder Elbow Surg 5(6):449–457PubMedCrossRefGoogle Scholar
  21. 21.
    Jarvholm V, Styf J, Suurkula M, Herberts P (1988) Intramuscular pressure and muscle blood flow in the supraspinatus. Eur J Appl Physiol 58:219–224CrossRefGoogle Scholar
  22. 22.
    Johannsen HV, Andersen NH, Sojbjerg JO, Sneppen O (1997) Arthroscopic subacromial decompression. Ugeskr Laeger 159(2):166–170PubMedGoogle Scholar
  23. 23.
    Klassen TP, Wiebe N, Russell K, Stevens K, Hartling L, Craig WR et al (2002) Abstracts of randomized controlled trials presented at the society for pediatric research meeting: an example of publication bias. Arch Pediatr Adolesc Med 156:474–479PubMedGoogle Scholar
  24. 24.
    Lees-Haley P (1997) Attorneys influence expert evidence in forensic psychological and neuropsychological cases. Assessment 4:321–324Google Scholar
  25. 25.
    McKee MD, Yoo DJ (2000) The effect of surgery for rotator cuff disease on general health status. J Bone Jt Surg 82-A(7):970–979Google Scholar
  26. 26.
    Michener LA, Leggin BG (2001) A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther 14(2):68–76PubMedGoogle Scholar
  27. 27.
    Michener LA, McClure PW, Sennett BJ (2002) American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg 11(6):587–594PubMedCrossRefGoogle Scholar
  28. 28.
    Misamore MW, Ziegler DW, Rushton JL (1995) Repair of the rotator cuff. J Bone Jt Surg 77-A(9):1335–1339Google Scholar
  29. 29.
    Neer CS II (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Jt Surg 54:41–50Google Scholar
  30. 30.
    Nicholson GP (2003) Arthroscopic acromioplasty: a comparison between workers’ compensation and non-workers’ compensation population. J Bone Jt Surg 85-A(4):682–689Google Scholar
  31. 31.
    Noerdlinger MA, Cole BJ, Stewart M, Post M (2002) Results of pectoralis major transfer with fascia lata autograft augmentation for scapula winging. J Shoulder Elbow Surg 11(4):345–350PubMedCrossRefGoogle Scholar
  32. 32.
    Ogilvie-Harris DJ, Wiley AM, Sattarian J (1990) Failed acromioplasty for impingement syndrome. J Bone Jt Surg Br 72-B(6):1070–1072Google Scholar
  33. 33.
    Olsewski JM, Depew AD (1994) Arthroscopic subacromial decompression and rotator cuff debridement for stage II and stage III impingement. Arthroscopy 10(1):61–68PubMedCrossRefGoogle Scholar
  34. 34.
    Paulos LE, Franklin JL (1990) Arthroscopic shoulder decompression development and application. Am J Sports Med 18(3):235–244PubMedCrossRefGoogle Scholar
  35. 35.
    Paulos LE, Kody MH (1994) Arthroscopically enhanced “miniapproach” to rotator cuff repair. Am J Sports Med 22(1):19–25PubMedCrossRefGoogle Scholar
  36. 36.
    Rainville J, Sobel JB, Hartigan C, Wright A (1997) The effect of compensation involvement on the reporting of pain and disability by patients referred for rehabilitation of chronic low back pain. Spine 22(17):2016–2024PubMedCrossRefGoogle Scholar
  37. 37.
    Roddey TS, Olson SL, Cook KF, Gartsman GM, Hanten W (2000) Comparison of the University of California–Los Angeles shoulder scale and the simple shoulder test with the shoulder pain and disability index: single-administration reliability and validity. Phys Ther 80(8):759–768, AugPubMedGoogle Scholar
  38. 38.
    Sallay PI, Hunker PJ, Brown L (2005) Measurement of baseline shoulder function in subjects receiving workers’ compensation versus noncompensated subjects. J Shoulder Elbow Surg 14(3):286–291PubMedCrossRefGoogle Scholar
  39. 39.
    Shinners TJ, Noordsij PG, Orwin JF (2002) Arthroscopically assisted mini-open rotator cuff repair. Arthroscopy 18(1):21–26PubMedCrossRefGoogle Scholar
  40. 40.
    Silverstein B, Viikari-Juntura E, Kalat J (2002) Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, and upper extremity in Washington state, 1990–1998. Am J Ind Med 41:149–169PubMedCrossRefGoogle Scholar
  41. 41.
    Smith KL, Harryman DT II, Antoniou J, Campbell B, Sidles JA, Matsen FA III (2000) A prospective, multipractice study of shoulder function ad health status in patients with documented rotator cuff tears. J Shoulder Elbow Surg 9(5):395–402PubMedCrossRefGoogle Scholar
  42. 42.
    Spangehl MJ, Hawkins RH, McCormack RG, Loomer RL (2002) Arthroscopic versus open acromioplasty: a prospective, randomized, blinded study. J Shoulder Elbow Surg 11(2):101–107PubMedCrossRefGoogle Scholar
  43. 43.
    Svendsen SW, Gelineck J, Mathiassen SE, Bonde JP, Frich LH, Stengaard-Pedersen K et al (2004) Work above shoulder level and degenerative alterations of the rotator cuff tendons: a magnetic resonance imaging study. Arthritis Rheum 50(10):3314–3322PubMedCrossRefGoogle Scholar
  44. 44.
    Viola RW, Boatright KC, Smith KL, Sidles JA, Matsen FA III (2000) Do shoulder patients insured by workers’ compensation present with worse self-assessed function and health status? J Shoulder Elbow Surg 9(5):368–372PubMedCrossRefGoogle Scholar
  45. 45.
    Waddell G, McCulloch J, Kummel E, Venner R (1980) Nonorganic physical signs in low back pain. Spine 5(2):117–125PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Hong KongChina

Personalised recommendations