TY - JOUR
T1 - Increased Risk of Surgical-Site Infection and Need for Manipulation Under Anesthesia for Those Who Undergo Open Versus Arthroscopic Rotator Cuff Repair
AU - Wang, Kevin Y.
AU - Agarwal, Amil R.
AU - Xu, Amy L.
AU - Best, Matthew J.
AU - Kreulen, R. Timothy
AU - Jami, Meghana
AU - McFarland, Edward G.
AU - Srikumaran, Uma
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: U.S. reports personal fees and other from Tigon Medical; personal fees from Conventus, Fx Shoulder USA, and Orthofix; grants from DePuy Synthes, Arthrex, Wright, and Smith & Nephew; personal fees from Heron and Pacira; and grants from ASES and OMEGA, outside the submitted work. In addition, he has a patent from Conventus pending, a patent from Fx Shoulder USA pending, and a patent from Tigon Medical issued. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2021 The Authors
PY - 2022/4
Y1 - 2022/4
N2 - Purpose: To compare 90-day postoperative complications, health care use, 2-year and 5-year rates of reoperation and manipulation under anesthesia, and costs at the 30-day, 90-day, and 1-year postoperative intervals following open and arthroscopic rotator cuff repair (RCR). Methods: Patients who underwent an open or arthroscopic RCR with minimum 5-year follow-up were identified in a national database (PearlDiver Technologies) using Common Procedural Terminology and International Classification of Diseases codes. These patients were then stratified into 2 cohorts: open RCRs and arthroscopic RCRs. These cohorts were propensity-matched based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index>30). 90-day medical complications, 2-year and 5-year surgical complications, and reimbursements at the 30-day, 90-day and 1-year postoperative intervals were assessed. Bivariate statistics were performed using χ2 tests, Fisher exact tests, and Student t tests where appropriate. Reimbursements included the reimbursement for the index surgery as well as any reimbursements during the specified postoperative interval related to the index surgery. Results: In total, 3,266 patients who underwent open RCR were matched with 3,266 patients who underwent arthroscopic RCR. Compared with patients who underwent arthroscopic RCR, patients who underwent open RCR were at significantly increased risk of 90-day surgical-site infection (0.89% vs 0.34%, P =.004), undergoing manipulation under anesthesia (MUA) within 2 years of surgery (1.65% vs 0.95%, P =.012), and undergoing MUA within 5 years of surgery (1.75% vs 1.10%, P =.028). There were no significant differences in any other postoperative complications, reoperation rates, or reimbursements between open RCR and arthroscopic RCR (all, P >.05). Conclusions: Patients undergoing open RCR were at increased risk of 90-day surgical-site infection and MUA both within 2 years and within 5 years of surgery in this study cohort. Level of Evidence: Level III, retrospective cohort study.
AB - Purpose: To compare 90-day postoperative complications, health care use, 2-year and 5-year rates of reoperation and manipulation under anesthesia, and costs at the 30-day, 90-day, and 1-year postoperative intervals following open and arthroscopic rotator cuff repair (RCR). Methods: Patients who underwent an open or arthroscopic RCR with minimum 5-year follow-up were identified in a national database (PearlDiver Technologies) using Common Procedural Terminology and International Classification of Diseases codes. These patients were then stratified into 2 cohorts: open RCRs and arthroscopic RCRs. These cohorts were propensity-matched based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index>30). 90-day medical complications, 2-year and 5-year surgical complications, and reimbursements at the 30-day, 90-day and 1-year postoperative intervals were assessed. Bivariate statistics were performed using χ2 tests, Fisher exact tests, and Student t tests where appropriate. Reimbursements included the reimbursement for the index surgery as well as any reimbursements during the specified postoperative interval related to the index surgery. Results: In total, 3,266 patients who underwent open RCR were matched with 3,266 patients who underwent arthroscopic RCR. Compared with patients who underwent arthroscopic RCR, patients who underwent open RCR were at significantly increased risk of 90-day surgical-site infection (0.89% vs 0.34%, P =.004), undergoing manipulation under anesthesia (MUA) within 2 years of surgery (1.65% vs 0.95%, P =.012), and undergoing MUA within 5 years of surgery (1.75% vs 1.10%, P =.028). There were no significant differences in any other postoperative complications, reoperation rates, or reimbursements between open RCR and arthroscopic RCR (all, P >.05). Conclusions: Patients undergoing open RCR were at increased risk of 90-day surgical-site infection and MUA both within 2 years and within 5 years of surgery in this study cohort. Level of Evidence: Level III, retrospective cohort study.
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U2 - 10.1016/j.asmr.2021.11.012
DO - 10.1016/j.asmr.2021.11.012
M3 - Article
C2 - 35494279
AN - SCOPUS:85124131057
SN - 2666-061X
VL - 4
SP - e527-e533
JO - Arthroscopy, Sports Medicine, and Rehabilitation
JF - Arthroscopy, Sports Medicine, and Rehabilitation
IS - 2
ER -