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Evaluating the Effect of Rotator Cuff Repair With Concomitant Distal Claviculectomy on 2 and 4 Year Reoperation Rates
Zachary C Pearson1, Amil R Agarwal, Alex Garcia
1From the Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD (Dr. Pearson, Dr. Agarwal, Dr. Mikula, Dr. Best, and Dr. Srikumaran), and the Department of Orthopaedic Sports Medicine, The Steadman Clinic, Vail, CO (Mr. Garcia and Dr. Rupp).
Summary
Concomitant distal claviculectomy (DC) during rotator cuff repair (RCR) reduces overall revision surgery rates but increases the likelihood of subsequent distal clavicle surgery.
Area of Science:
- Orthopedic Surgery
- Shoulder Surgery
- Sports Medicine
Background:
- Conflicting literature exists regarding the effectiveness of distal claviculectomy (DC) during rotator cuff repair (RCR) for preventing revision surgery.
- This study aimed to compare revision surgery rates between RCR with DC and RCR without DC.
Purpose of the Study:
- To investigate the impact of concomitant distal claviculectomy (DC) on revision surgery rates following rotator cuff repair (RCR).
Main Methods:
- Retrospective cohort analysis of a national claims database.
- Identified patients undergoing primary RCR with or without DC (open or arthroscopic).
- Assessed 4-year revision surgery rates using univariate and multivariable logistic regression analysis.
Main Results:
- 131,232 patients were included in the analysis.
- RCR with DC showed higher odds of subsequent DC procedures (OR 1.49) but lower odds of any revision surgery (OR 0.87) within 4 years.
- Patients undergoing RCR with DC had increased odds of distal clavicle revision surgery at 2 years (85%) and 4 years (49%).
Conclusions:
- Concomitant DC during RCR is associated with lower overall revision surgery rates within 4 years.
- However, RCR with DC significantly increases the likelihood of requiring distal clavicle revision surgery.
- The decision to perform concomitant DC should weigh the reduced overall revision risk against the increased risk of distal clavicle revision.