Travel Distance Does Not Affect Outcomes After Arthroscopic Rotator Cuff Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Patient Outcomes Research

Background:

• Arthroscopic rotator cuff repair (RCR) outcomes are typically assessed using patient-reported outcome measures (PROMs).
• Achieving the minimal clinically important difference (MCID) is a key indicator of successful RCR.
• The influence of patient travel distance on achieving MCID after RCR remains under investigation.

Purpose of the Study:

• To evaluate the impact of travel distance on achieving MCID for PROMs after arthroscopic RCR.
• To compare outcomes between patients living closer to (<50 miles) and farther from (>50 miles) a high-volume RCR center.

Main Methods:

• Retrospective review of 385 patients undergoing primary arthroscopic RCR with at least 1-year follow-up.
• Patients categorized into local (<50 miles) and referral (>50 miles) groups based on driving distance.
• Analysis of American Shoulder and Elbow Score (ASES), Single Assessment Numeric Evaluation (SANE), and Constant scores; MCID achievement assessed using chi-square analysis and logistic regression.

Main Results:

• No significant difference in MCID achievement for any PROM between local and referral groups (94% vs. 90%).
• Subgroup analysis by tear complexity (1 tendon vs. >2 tendons) showed no significant differences in preoperative PROMs or postoperative MCID.
• Logistic regression controlling for age, sex, income, insurance, and tear characteristics found no effect of travel distance on MCID.

Conclusions:

• Travel distance to a high-volume arthroscopic RCR center does not affect the likelihood of achieving MCID for PROMs at 1 year postoperatively.
• These findings suggest that patient location relative to the surgical center does not compromise functional recovery after RCR.
• High-volume centers can effectively serve a geographically diverse patient population for arthroscopic rotator cuff repair.