What question did this study set out to answer?

The study aims to evaluate how coronary artery disease and peripheral artery disease affect outcomes after rotator cuff repair.

February 12, 2026Arthroscopy The Journal of Arthroscopic and Related Surgery0 citations

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Coronary Artery Disease and Peripheral Artery Disease Are Associated With Increased Rates of Retear and Postoperative Complications Following Primary Arthroscopic Rotator Cuff Repair

MVMatthew VaranoRush University Medical Center CHCatherine HandRush University Medical Center HEHenry EilenRush University Medical Center

Key Points

The study aims to evaluate how coronary artery disease and peripheral artery disease affect outcomes after rotator cuff repair.
Conducted a retrospective matched cohort study using a national insurance claims database.
Identified patients undergoing primary arthroscopic rotator cuff repair and stratified them by CAD and PAD status.
Matched cohorts based on age, gender, and tear type for comparison.
Analyzed primary outcomes of retear rates and secondary outcomes of postoperative complications using multivariate logistic regression.
Patients with CAD only had an odds ratio (OR) of retear at 6 months of 1.03, while PAD only was 1.07 and both was 1.04 (P = .029).
Increased 90-day complication rates were found in all cohorts, with CAD (OR 6.07), PAD (OR 4.06), and both (OR 14.51) showing significant differences (P < .001).
Specific complications included higher rates of pneumonia and pulmonary embolism in the combined CAD and PAD group.

Abstract

Purpose To assess the influence of peripheral artery disease (PAD) and coronary artery disease (CAD) on rotator cuff repair (RCR) outcomes and postoperative complications. Methods A retrospective matched cohort study was conducted using the PearlDiver national insurance claims database. Patients undergoing primary arthroscopic RCR (ARCR) between 2016 and 2020 were identified and stratified into CAD only, PAD only, both CAD and PAD, and control cohorts. A 1:1 matching protocol by age, gender, and tear type was implemented. Patients were further stratified by disease severity based on prior vascular interventions. Primary outcomes included retear rates and revision RCR. Secondary outcomes comprised 90‐day postoperative complications. Multivariate logistic regression adjusted for Charlson Comorbidity Index (CCI), age, and gender. Results Among 358,405 patients undergoing RCR, 45,016 had CAD only, 23,806 had PAD only, and 19,732 had both CAD and PAD. Matched cohorts of CAD only (n = 15,693), PAD only (n = 15,693), both CAD and PAD (n = 15,693), and controls (n = 15,693) demonstrated significantly higher retear rates in CAD only, PAD only, and both CAD and PAD cohorts at 6 months (OR 1.03 vs 1.07 vs 1.04, P = .029), 1 year (OR 1.04 vs 1.09 vs 1.06, P = .003), and 4 years (OR 1.05 vs 1.09 vs 1.08, P < .001). Ninety‐day complication rates were also significantly increased across CAD, PAD, and both CAD and PAD groups (OR 6.07 vs 4.06 vs 14.51, P < .001), including ED visits (OR 5.21 vs 3.35 vs 10.81, P < .001), infections (OR 3.98 vs 3.12 vs 9.74, P < .001), acute kidney injury (OR 9.06 vs 3.99 vs 20.10, P < .001), pneumonia (OR 6.11 vs 3.29 vs 13.50, P < .001), pulmonary embolism (OR 18.91 vs 15.27 vs 46.88, P < .001), and sepsis (OR 5.20 vs 3.50 vs 11.85, P < .001). Revision rates trended higher but were not statistically significant at 6 months (OR 0.71 vs 0.91 vs 0.97, P = .57), 1 year (OR 1.22 vs 0.96 vs 1.20, P = .47), or 4 years (1.34 vs 1.07 vs 1.37, P = .08). Conclusions CAD and PAD significantly increase the risk of rotator cuff retear at 6 months, 1 year, and 4 years in addition to significantly increasing the risk of postoperative complications within 90 days following ARCR. Level of Evidence Level III, retrospective comparative case series.

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Cite This Study

Varano et al. (Mon,) studied this question.

synapsesocial.com/papers/698d6d795be6419ac0d52741 https://doi.org/https://doi.org/10.1002/arj.70004

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