Increased operative time has a negative impact on clinical outcome in arthroscopic rotator cuff repair.

Abstract

Few data are available about the impact of operative time on outcome of rotator cuff repair. The aim of this study was to evaluate the impact of operative time on clinical outcome and tendon healing after arthroscopic rotator cuff repair. Patients operated on for distal supraspinatus tear in our institution between 2012 and 2018 were included retrospectively. Operative time, from skin incision until skin closure, was extracted from medical files. For statistical analysis, operative time was treated as a quantitative variable. Endpoints were clinical outcome (Constant score, range of motion), tendon healing (on CT or MRI) and complications at 1year. The significance threshold was set at p = 0.05. A total of 219 Patients, with a mean age of 54.6years (range 40-70years), were included. Mean operative time 44.9min (range 14-140min). Significant correlations (p < 0.05) were found for Constant score and external rotation at 1year: increasing operative time by 1min led to a decrease in Constant score of 0.115 points, or 6.9 points for a 60-min increase (p = 0.0167) and a decrease in external rotation of 0.134°, or 8.04° for a 60-min increase (p = 0.0214). No significant correlations were found for anterior elevation at 1year (p = 0.2577), tendon healing at 1year (p = 0.295) or onset of complications during follow-up (p = 0.193). The minimal clinically important difference in Constant score in patients undergoing rotator cuff surgery is between 6 and 10 points. An increase of more than 60min in operative time significantly impacted clinical outcome of arthroscopic distal supraspinatus repair, but not tendon healing. Level III: Retrospective Cohort Design. Therapeutic Study.