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Updated: Sep 21, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Myocardial Infarction Within 6 Months Before Arthroscopic Rotator Cuff Repair Is Associated With Significantly
Romir P Parmar1, Muaz Mian2, Alejandro M Holle3
1University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, U.S.A.
Purpose:
To evaluate the association between myocardial infarction (MI) timing within 2 years prior to arthroscopic rotator cuff repair (aRCR) and postoperative cardiac, medical, and surgical complications.
Methods:
The PearlDiver Mariner Database (2010-2022) was queried to identify patients undergoing aRCR (CPT-29827). Patients with an MI within 2 years before surgery were propensity matched 1:4 to controls without MI based on demographics and comorbidities. Subgroup analyses evaluated MI timing (0-6, 6-12, 12-18, and 18-24 months), MI type (type 1 vs type 2, ST-elevation MI vs non-ST-elevation MI), percutaneous coronary intervention (PCI) status, guideline-directed medical therapy, and infarct location. Primary outcomes included 90-day medical and 2-year surgical complications. Odds ratios with 95% confidence intervals were calculated.
Results:
A total of 2886 patients with prior MI were matched to 10,613 controls. Prior MI increased the odds of postoperative MI (odds ratio, 3.48; 95% confidence interval, 2.13, 8.32). The highest risk of postoperative MI occurred when aRCR was performed within 6 months of MI (odds ratio, 7.55; 95% confidence interval, 4.38, 13.01), with no significant elevation beyond this window. Type 1 MI was associated with postoperative MI and mortality, whereas type 2 MI was associated with acute kidney injury, pneumonia, and readmission. Both ST-elevation MI and non-ST-elevation MI were linked to increased postoperative MI risk. Patients without PCI showed broader postoperative complications, including mortality, acute kidney injury, and stiffness, compared with those who underwent PCI.
Conclusions:
Recent MI is associated with increased postoperative risk of MI after aRCR, particularly when surgery is performed within 6 months. Patients without PCI experience additional vulnerability.
Level Of Evidence:
Level III, retrospective comparative study.
