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Variation in orthopaedic surgeons' perceptions about the indications for rotator cuff surgery
Warren R Dunn1, Bruce R Schackman, Colin Walsh
1The Hospital for Special Surgery, 525 East 70th Street, New York, NY 10021, USA. warren.dunn@vanderbilt.edu
The Journal of Bone and Joint Surgery. American Volume
|September 6, 2005
Summary
Surgeons with higher rotator cuff repair volumes perceive better outcomes, despite significant variation and lack of clinical agreement in decision-making. Lower volume surgeons are more pessimistic about rotator cuff surgery results.
Area of Science:
- Orthopaedic Surgery
- Surgical Decision-Making
- Epidemiology
Background:
- Rotator cuff repair rates vary significantly across populations.
- Understanding surgeon attitudes is crucial for standardizing care.
Purpose of the Study:
- To assess orthopaedic surgeons' attitudes towards rotator cuff surgery decision-making.
- To explore the relationship between these attitudes and surgical case volumes.
Main Methods:
- A survey was distributed to randomly selected orthopaedic surgeons.
- The survey included questions on clinical opinions and hypothetical cases related to rotator cuff tears.
- Respondents were screened for recent patient treatment or referral for rotator cuff tears.
Main Results:
- A negative correlation was found between estimated repair failure rates and surgeon procedure volume.
- Surgeons with higher volumes were less likely to favor open rotator cuff repair techniques.
- Clinical agreement was limited, with consensus only on 4 of 9 clinical questions.
Conclusions:
- Significant variability exists in orthopaedic surgeons' decision-making for rotator cuff surgery.
- Higher surgical volumes correlate with more positive perceptions of rotator cuff repair outcomes.
- A lack of widespread clinical agreement highlights potential areas for practice guideline development.