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Published on: July 5, 2011
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COVID-19-related rotator cuff repair delay
Karch M Smith1, J Cade Wheelwright1, Garrett V Christensen2
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
JSES International
|January 12, 2022
Summary
A COVID-19-related delay in rotator cuff tear (RCT) surgery did not significantly impact patient outcomes. However, delayed surgery showed a trend toward lower healing rates on MRI, suggesting potential negative effects on healing.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Surgical Outcomes
Background:
- Nonoperative treatment for degenerative rotator cuff tears (RCTs) is common, but its impact on subsequent surgical repair outcomes is debated.
- The COVID-19 pandemic necessitated delays in elective surgeries, providing a unique opportunity to study the effects of delayed RCT treatment.
- Understanding the consequences of delayed surgical intervention is crucial for optimizing patient care pathways.
Purpose of the Study:
- To evaluate the clinical outcomes and healing rates of patients undergoing delayed arthroscopic rotator cuff repair compared to those receiving timely surgery.
- To assess the impact of a COVID-19-induced surgical delay on patient-reported functional scores and pain levels.
- To investigate the effect of delayed surgical treatment on rotator cuff healing as visualized by magnetic resonance imaging (MRI).
Main Methods:
- Prospective study comparing two groups: patients with delayed rotator cuff repair (due to COVID-19) and a control group with immediate repair.
- Data collection included Simple Shoulder Test, American Shoulder and Elbow Surgeons (ASES) scores, and visual analog scale (VAS) for pain preoperatively and at six months postoperatively.
- Postoperative MRI scans were obtained at six months to assess rotator cuff healing. Power analysis indicated a need for 14 patients for 90% power.
Main Results:
- Fifteen patients were included in each group, with 100% follow-up at six months.
- No significant preoperative differences in demographics or tear characteristics were observed between the delayed and control groups.
- While patient-reported outcomes (ASES, VAS, Simple Shoulder Test) improved significantly postoperatively in both groups, there were no significant differences between the groups. MRI showed 58% healing in the delayed group versus 85% in the control group (P=0.202).
Conclusions:
- A two-month delay in rotator cuff tear surgery due to COVID-19 did not significantly affect patient-reported outcomes.
- A trend towards reduced healing rates on MRI was observed in the delayed surgery group, although this was not statistically significant in this cohort.
- Larger studies are warranted to confirm if delays in rotator cuff tear treatment negatively impact healing rates.
