Key result
Arthroscopic rotator cuff repair was associated with a significantly lower risk of complications compared with open or mini-open repair (RR 0.71; 95% CI 0.66-0.77; P<0.001).
Why the study?
The study was conducted to ascertain trends and reported complication rates of arthroscopic versus open or mini-open rotator cuff repairs among American Board of Orthopaedic Surgery Part II examinees.
Does arthroscopic rotator cuff repair reduce complication rates compared to open or mini-open repair?
Cohort (n=31,907)
Yes
Does arthroscopic rotator cuff repair reduce complication rates compared to open or mini-open repair?
Relative Risk: 0.71 (95% CI 0.66–0.77)
p-value: p=< .001
Arthroscopic rotator cuff repair has become increasingly common and is associated with a lower risk of complications compared to open or mini-open repair among ABOS Part II examinees.
May support arthroscopic preference to reduce complications; extends observational data but leaves open need for RCTs.
PURPOSE: To ascertain trends and reported complication rates of arthroscopic and open or mini-open rotator cuff repairs (RCRs) reported by American Board of Orthopaedic Surgery (ABOS) Part II examinees between 2007-2017. METHODS: The ABOS database was queried for both arthroscopic RCR (International Classification of Diseases code 29827) and open or mini-open RCR (International Classification of Diseases codes 23410 and 23412) performed by Part II examinees from 2007-2017. A comparison between overall procedure rates, as well as reported complications (anesthetic, medical, surgical, reoperations, and readmissions) associated with the respective repair technique, was performed. RESULTS: From 2007-2017, a total of 31,907 RCRs were reported by Part II examinees. Of those, 85.2% (n = 27,189) were arthroscopic whereas 14.8% (n = 4,718) were open or mini-open. The rate of arthroscopic RCR increased from 73% (n = 2,138) in 2007 to 90% (n = 2,031) in 2017, whereas the rate of open or mini-open RCR decreased from 27% (n = 771) to 10% (n = 234) during the same period. Rates of reported annual complications were significantly lower for arthroscopic RCR (7.4%-16.2%) than for open or mini-open RCR (12.9%-30.3%) for each of the past 6 years (2012-2017) (P < .001). Arthroscopic RCR had an overall lower cumulative occurrence of complications than open or mini-open RCR over the past decade (2007-2017) (P < .001). The relative risk of complications for arthroscopic RCR compared with open RCR was 0.71 (95% confidence interval, 0.66-0.77). CONCLUSIONS: ABOS Part II examinees reported an increased practice of arthroscopic RCR in comparison with open or mini-open RCR over the past 10 years. Reported annual complication rates have been significantly lower for arthroscopic RCR over the past 6 years, with an overall lower cumulative rate from 2007-2017. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
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Kelly et al. (2019) conducted a cohort in Rotator cuff tear (n=31,907). Arthroscopic rotator cuff repair vs. Open or mini-open rotator cuff repair was evaluated on Complications (anesthetic, medical, surgical, reoperations, and readmissions) (RR 0.71, 95% CI 0.66-0.77, p=< .001). Arthroscopic rotator cuff repair was associated with a significantly lower risk of complications compared with open or mini-open repair (RR 0.71; 95% CI 0.66-0.77; P<0.001).
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