Rotator Cuff Repair Surgery Research Articles

Rotator Cuff Tear and Associated Risk Factors. The Mutual Role of Medical Conditions

■: Several medical conditions (diabetes, cardio-vascular diseases, hypercholesterolemia etc.) or modifiable behavioral habits (smoking habit and alcohol assumption) capable of causing a damage to the peripheral microcirculation are considered potential risk factors for degeneration/tear of the rotator cuff. The aim of the study was to analyse and quantify how the association of multiple known risk factors is more effective than the predisposing action of a single factor. 308 consecutive patients who underwent arthroscopic repair of a full-thickness Rotator Cuff Tear (RCT) represented the case group. The control group included 388 consecutive healthy asymptomatic subjects for shoulder pathologies. A multivariable prognostic model for the prediction of rotator cuff tear has been performed to analyse the mutual effect of multiple risk factors. With a correct classification estimated at 70.6% a smoker patient (OR=2.405; CI95%=1.645-3.516) with hypercholesterolemia (OR=1.976; CI95%=1.408-2.771), diabetes (OR=2.362; CI95%=1.241-4.493) and arterial hypertension (OR=1.630; CI95%=1.156-2.300) has a higher chance of developing a rotator cuff tear surgery compared to a peer non-smoker healthy subject. Probability of a smoker patient suffering from hypercholesterolemia, diabetes, and arterial hypertension to undergo rotator cuff repair surgery is not given by the sum of the probabilities of each condition but increases drammatically. Each pathology interacts with each other; dramatically increasing the risk of developing a cuff tear. Level of Evidence: III Retrospective Study

What influences the decision to undergo rotator cuff repair surgery: A survey of clinician's perspectives

What influences the decision to undergo rotator cuff repair surgery: A survey of clinician's perspectives

Changes in shoulder function and muscle strength following rehabilitation exercise program in male patients with forward shoulder posture undergoing rotator cuff repair

BackgroundAbnormal posture is known to affect the efficacy of exercise therapy for musculoskeletal diseases. However, no studies to date have examined the effect of exercise programs should take into account the posture of the upper body in patients with rotator cuff disease. This study aimed to assess how rotator cuff and corrective exercises impact shoulder function and muscle strength post-arthroscopic rotator cuff repair surgery, providing tailored rehabilitation programs for patients with forward posture.MethodsNinety male patients who underwent arthroscopic rotator cuff repair participated in this study. The patients were randomly divided into three groups corrective exercise group (CEG, n = 29), rotator cuff exercise group (REG, n = 27), and control group (CG, n = 28). Each group was instructed to apply different exercise programs to correct posture and enhance rotator cuff strength. All patients were checked by the American Shoulder and Elbow Surgeons (ASES) score, Constant score and muscle strength, and range of motion preoperatively and postoperatively at 6 months and 1 year.ResultsASES shoulder function scores showed significant difference between the three groups (p = 0.002, F = 7.03), indicating that the corrective exercise program was more beneficial than rotator cuff exercises (p = 0.009, F = 3.78). A significant intergroup difference in mean Constant score was also noted (p = 0.025, F = 3.86), while a statistically significant interaction between time and group was observed (p = 0.032, F = 2.96).ConclusionsThese results suggested that a corrective exercise program can improve shoulder muscle strength and function after rotator cuff repair in male patients with a forward shoulder posture.

Early Postoperative Pain is Similar after Arthroscopic Rotator Cuff Repair versus Short-Stay Shoulder Arthroplasty: A Prospective Study.

IntroductionOne of the barriers to counseling patients for shoulder arthroplasty (SA) is the anticipated pain after surgery. This can be contrasted with the common perception of arthroscopic rotator cuff repair (RCR) surgery being less painful due to the less invasive nature of the procedure. We conducted a prospective study comparing postoperative pain levels and narcotic consumption after SA compared to those after RCR. MethodsThis prospective study enrolled 102 patients undergoing short-stay SA and RCR at a single hospital. 50 patients underwent RCR and 52 underwent SA. All participants received a multimodal pain regimen consisting of an interscalene block with liposomal bupivacaine and one of two oral pain medication regimens. Patients were provided a daily pain diary to be completed for 14 postoperative days that tracked pain levels, narcotic consumption, and pain location. Patients were excluded for age <40, revision surgery, SA for fracture, history of chronic opioid use, or an inability to adhere to study protocol. Demographics, visual analogue scale (VAS) scores, and pain sensitivity questionnaires (PSQ) were collected preoperatively. Primary study outcomes were daily VAS pain scores and narcotic consumption during the 14 days after surgery. ResultsRCR patients were younger (60.6 vs. 68.9 years; p<0.01) but other demographics, preoperative pain, and PSQ scores were similar between groups. Peak mean VAS pain levels for RCR and SA each occurred on postoperative (POD) 2 and were 4.4 ± 3.1 and 5.1 ± 2.7 respectively (p=0.214). There was no significant difference in VAS pain during the 14-day postoperative period between RCR and SA patients (p>0.05) or between anatomic SA and reverse SA (p>0.05). Narcotic usage was greater for RCR patients at POD 7 (0.5 vs. 0.2 tablets; p=0.039) and 8 (0.5 vs. 0.2 tablets; p=0.015) compared to SA patients. ConclusionsOur study demonstrated that postoperative pain levels do not significantly differ between RCR and short-stay SA, with greater narcotic usage observed for RCR at one week after surgery. These findings support the notion that despite the increased invasiveness of SA, early postoperative pain is comparable with early pain after RCR.

Real-world clinical and economic impacts of delayed rotator cuff repair surgery in Japan: analysis of a large claims database

Real-world clinical and economic impacts of delayed rotator cuff repair surgery in Japan: analysis of a large claims database

Improved patient reported outcomes with knotless double-row rotator cuff repair with and without lateral row biceps tenodesis at 2- and 5-years

BackgroundThe purpose of this study is to report outcomes of an arthroscopic knotless double-row (DR) rotator cuff repair (RCR) technique at 2- and 5- years postoperatively, and to compare clinical outcomes in patients undergoing knotless DR RCR with incorporated lateral row biceps tenodesis vs. those without lateral row biceps tenodesis. MethodsAll primary RCR surgeries were performed by a single surgeon at a single institution using a knotless transosseous equivalent (TOE) technique. The postoperative rehabilitation protocol was standardized for all patients. The primary outcomes collected included ASES Function, ASES Index, SANE, SST, VR-12 physical and mental, and VAS scores. ResultsThree hundred forty-two patients met inclusion criteria, of which 262 patients underwent isolated RCR and 61 underwent RCR with a concomitant lateral row biceps tenodesis, 15 underwent RCR with concomitant tenotomy and 4 had RCR with débridement of the biceps. Significant improvements in VAS, ASES, SANE, SST, and VR-12 scores were observed at all time points in all patient groups. No statistically significant differences in outcomes were noted in patients undergoing RCR with a lateral row tenodesis vs. those undergoing RCR alone. Similarly, no differences were seen when stratified by age, sex, BMI, Worker’s Compensation (WC) status, smoking, and diabetes mellitus (DM). Based on ASES, 81% of patients met minimum clinically important difference (MCID), and 64% met maximum outcome improvement (MOI) at 1-year postoperatively. ConclusionKnotless DR TOE arthroscopic RCR significantly improves patient-reported clinical outcomes at 1-, 2- and 5-year follow-ups. These results are reflected in clinical practice because 80% achieve MCID postoperatively. Patient-related factors, including BMI, age, sex, WC, and DM do not significantly affect patient-reported outcomes in the first 5 years after surgery. Smokers have worse baseline scores which persist at 2-year follow-up. Lastly, adding an arthroscopic lateral row biceps tenodesis in knotless DR TOE arthroscopic RCR provides similar clinical outcomes to knotless DR TOE arthroscopic RCR without biceps tenodesis.

Poster 146: Higher Reoperation Rates Following Primary Rotator Cuff Repair in Patients Screening Positive for Depression

Objectives: Recent studies have identified an association between preoperative depression and worse outcomes following arthroscopic rotator cuff repair (RCR) surgery, including lower patient-reported outcomes, increased pain and impairment, and higher rates of complications. Patient Health Questionnaire-2 (PHQ-2) is a commonly administered screening tool for measuring depressive symptoms; however, the relationship between PHQ-2 and postoperative outcomes after RCR is not yet established. The purpose of this study is to investigate the association between depression and reoperation rates in patients undergoing primary RCR. Methods: This retrospective chart review evaluated data from all patients who underwent elective primary RCR at 1 health system between March 2016 and December 2021 and had a PHQ-2 score at least 6 months prior to their surgery. The PHQ-2 is a validated tool used to screen for depression with scores ranging from 0-6. Patients were categorized as either depressed (PHQ-2 ≥ 2) or nondepressed (PHQ-2 &lt; 2). Patients &lt;18 years old, history of prior RCR, and patients without PHQ-2 scores within 6 months of surgery were excluded from the study. The primary outcome was to compare reoperation rate, defined as the need for any subsequent surgery related to the primary RCR between depressed and non-depressed patients. The secondary outcome was a comparison of postoperative health care utilization, which included emergency department visits and hospital readmissions within 90 days. Depressed patients were also propensity matched 1:1 to nondepressed patients via age, body mass index (BMI), and tear size for a subanalysis. Results: A total of 238 patients who underwent primary RCR were included with 84 depressed patients and 154 nondepressed patients. Significantly more patients were female (67% versus 46%; P = 0.002) in the depressed cohort compared to nondepressed. There was a significantly increased incidence of comorbid depression (63% vs 28%; P &lt; 0.001), anxiety (52% vs 17%; P &lt; 0.001), and substance use disorder (20% vs 6%; P &lt; 0.001) as well as a lower median household income (MHI) in the depressed cohort versus the nondepressed cohort ($58,451.93 ± $21,024.93 vs. $66,751.93 ± $22,654.45; P &lt; 0.001). Fifteen (17.9%) depressed patients underwent reoperation versus 10 (6.5%) nondepressed patients (P = 0.006). Mean time to reoperation in the depressed cohort was 11.7 months (0.8-35 months). In the subanalysis, 80 patients in the depressed cohort and 80 patients in the nondepressed cohort were matched. Depressed patients had significantly higher rates of comorbid depression (63% vs 18%; P &lt; 0.001), anxiety (52% vs 17%; P &lt; 0.001), and substance use disorder (20% vs 6%; P &lt; 0.001) and a lower MHI ($58,615.20 ± $21,455.12 vs $66,470.73 ± $22,996.49; P = 0.04). Fewer patients were employed full time (22% vs. 44%) and more were disabled (30% vs 8%) amongst the depressed cohort (P = 0.003). Amongst depressed patients, 14 patients (17.5%) versus 4 (5%) underwent reoperation (P = 0.01). No significant differences in postoperative emergency department visits, postoperative complications, or hospital readmissions were found between the depressed and nondepressed cohorts in either analysis. Conclusions: We found patients screening positive for depression preoperatively, as measured by PHQ-2, had a significantly higher reoperation rate following primary RCR compared to nondepressed patients. These patients were more likely to be female, have comorbid mental health diagnoses, no full-time employment, and a lower household income. Screening for depression preoperatively could be a useful adjunct for providers to better identify patients at risk for worse outcomes.

Clinical application of tranexamic acid in arthroscopic rotator cuff repair surgery: A randomized controlled trial.

To investigate whether intravenous administration of tranexamic acid (TXA) prior to arthroscopic rotator cuff repair improves operative blood loss, postoperative fibrinolytic index, inflammatory response, and postoperative pain. This was a prospective, double-blind, randomized controlled study. From January 2023 to February 2024, 64 patients who required arthroscopic rotator cuff repair were included and divided into tranexamic acid group (T group) group and control group (C group) according to the random number table method. In T group, 1000 mg TXA was administered intravenously 10 minutes before surgery, and an equivalent dose of normal saline was administered intravenously 10 minutes before surgery in C group. Intraoperative bleeding, postoperative fibrinolytic indexes, inflammatory indexes, pain scores, and occurrence of adverse effects were compared between the 2 groups. Intraoperative bleeding in T group was lower than that in C group (P < .05); D-D and FDP in T group were significantly lower than those in C group (P < .05); postoperative TNF-α and IL-6 in 2 groups was higher than that before operation and T group was lower than C group (P < .05); The pain scores of the 2 groups after operation were lower than those before operation (P < .05), and there was no difference between the 2 groups (P > .05). TXA is able to reduce blood loss and inflammatory reactions, modulate fibrinolytic function, and promote postoperative recovery in patients undergoing arthroscopic rotator cuff repair, with no elevated risk of complications.

CSP2023: 362 - Experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative interview study

CSP2023: 362 - Experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative interview study

CSP2023: 35 - Physiotherapist-led exercise versus waiting-list control for patients awaiting rotator cuff repair surgery: a pilot randomised controlled trial (POWER)

CSP2023: 35 - Physiotherapist-led exercise versus waiting-list control for patients awaiting rotator cuff repair surgery: a pilot randomised controlled trial (POWER)

Superior capsular reconstruction with the long head of the biceps tendon achieves excellent clinical results and low rotator cuff rerupture rates one year after cuff repair surgery.

To analyze the clinical one-year evolution of healed and rerupture lesions in patients who received a rotator cuff repair plus Superior Capsular Reconstruction (SCR) with the long head of the biceps (LHB). Moreover, to compare this evolution between men and women. A pilot study was conducted on patients who underwent a rotator cuff repair plus SCR with LHB between February 2021 and June 2022. All patients completed pre-operative and one-year post-operative evaluations for tendon type of tear and tendon integrity using Magnetic Resonance Imaging (MRI)after one year of the surgery. Besides, functionality was evaluated with the American Shoulder and Elbow Surgeons (ASES) score; the visual analog scale for pain (VAS); and the Constant score. A total of 38 patients completed the one-year final evaluation, they presented an increased functionality score to 83 and 86 in Constant and ASES scales (p < .001), respectively. Besides, 84% of the patients presented a healed cuff, while rerupture occurred in 16% of the patients. There were differences between the healed and rerupture patients in the total Constant score, with a remarkable increase in the strength subscale, almost double for patients with healed cuff (p < .001); in the same way, daily life activity score, and balance subscale increased, while pain score decreased in the healed cuff group (p < .05). There was no difference in functionality between men and women (p > .05). Besides, almost all patients achieved the MCID in both ASES and Constant total scores, irrespectively of the healing group. The cuff repair using SCR with the LHB achieved a low percentage of rerupture and a functional improvement after one year of follow-up. Patients who healed the lesion presented more strength and better performance in daily life activities than those with cuff repurture. Thus, SCR + LHB procedure can be considered an efficient technique for rotator cuff repair surgery for both men and women. Although a comparison with a control group is needed to confirm these findings.

The Effect of Denosumab on Rotator Cuff Repair in Women Aged 60 and over with Osteoporosis: A Prospective Observational Study.

In previous studies, denosumab, a RANKL human monoclonal antibody used in osteoporosis treatment, has shown efficacy in tendon healing after rotator cuff repair. This prospective study investigated the effects of denosumab on tendon healing, re-tear rates, and clinical outcomes post rotator cuff repair in women with osteoporosis. This was a prospective, observational study, employing propensity score matching for the control group. From March 2018 to March 2023, female patients over the age of 60 with normal bone density undergoing arthroscopic rotator cuff repair were selected as controls through propensity score matching (PSM) and compared with female patients of the same age group with osteoporosis who were receiving denosumab treatment. The control group was matched using 1-to-2 propensity score matching. Radiological examinations and functional outcomes were assessed preoperatively and at 6 months postoperatively. In the final analysis, the study comprised 34 patients in the denosumab treatment group (Group 1) and 68 patients in the control group (Group 2). The functional scores showed significant improvement at 6 months post-surgery in both groups. No significant difference in the functional scores was observed among the groups. The re-tear rate, defined according to Sugaya's classification (types IV and V) as re-tear, was slightly higher in Group 1 at 16.7% (6 of 34) compared to Group 2 at 11.7% (8 of 68), but the difference was not statistically significant (p = 0.469). The re-tear patterns, classified according to Rhee's classification, also showed no significant difference among the groups (Group 1: 2/4 of 6; Group 2: 4/4 of 8; p = 0.571). The occurrence of type I re-tear exhibited no significant difference between the two groups (5.9% vs. 5.9%; p = 1.000). The administration of denosumab following arthroscopic rotator cuff repair in women aged 60 and over with osteoporosis resulted in a re-tear rate that was similar to that observed in patients without osteoporosis. This result suggests that denosumab administration might be beneficial for rotator cuff healing, particularly in the context of osteoporosis, a known risk factor for increased retear rates. Therefore, comprehensive osteoporosis screening and treatment should be considered in conjunction with rotator cuff repair surgery in middle-aged women.

The impact of social deprivation on rotator cuff repair outcomes

BackgroundRotator cuff tears are a common orthopedic injury and the role of social determinants of health (SDoH) in surgical outcomes remains underexplored. The goal of this study was to investigate the correlation between social deprivation, measured by the Area Deprivation Index (ADI), and outcomes following arthroscopic rotator cuff repair. MethodsWe conducted a retrospective chart review on patients undergoing primary arthroscopic rotator cuff repair at a level one academic center between 2006 and 2019. Patient demographics (age, gender, race), comorbidities, ADI scores, range of motion, visual analog pain scores, and patient-reported outcomes (SST, ASES, and QuickDASH) were collected. Patients were stratified into terciles based on their relative level of deprivation. Statistical analysis was performed using ANOVA, t-tests, chi-square tests, and univariate/multivariate logistic regression. Results322 patients were included in this study. The most deprived group had a higher prevalence of diabetes compared to the least and intermediately deprived group (p<0.001). Massive tear occurrence was greater in the least deprived group (p=0.003) compared to the most deprived group. There was no difference in objective outcomes between groups. Patient-reported outcomes (SST, ASES, and QuickDASH) were worse in the most deprived group compared to the least and intermediate deprived groups. ConclusionSocial deprivation significantly affects patient-reported outcomes in rotator cuff repair surgery. While clinician-reported outcomes were consistent, patients' perceptions varied based on social determinants. Integrating SDoH considerations in orthopedic care is a promising next step in securing equitable approaches. However, more research is needed to validate and expand these findings.

ChatGPT-3.5 Responses Require Advanced Readability for the General Population and May Not Effectively Supplement Patient-Related Information Provided by the Treating Surgeon Regarding Common Questions About Rotator Cuff Repair

The purpose of this study was to investigate the accuracy of ChatGPT's responses to frequently asked questions (FAQ) prior to rotator cuff repair surgery. The ten most common FAQs related to rotator cuff repair were compiled from four institution websites. Questions were then input into ChatGPT-3.5 in one session. The provided ChatGPT-3.5 responses were analyzed by two orthopedic surgeons for reliability, quality, and readability using The Journal of the American Medical Association (JAMA) Benchmark criteria, the DISCERN score, and the Flesch-Kincaid Grade Level. The JAMA Benchmark criteria score was 0, indicating the absence of reliable source material citations. The mean Flesch-Kincaid Grade Level was 13.4 (range, 11.2-15.0). The mean DISCERN score was 43.4 (range, 36-51) indicating that the quality of the responses overall was considered fair. All responses cited making final decision-making to be made with the treating physician. ChatGPT-3.5 provided substandard patient-related information in alignment with recommendations from the treating surgeon regarding common questions around rotator cuff repair surgery. Additionally, the responses lacked reliable source material citations and the readability of the responses was relatively advanced with a complex language style. The findings of this study suggest that ChatGPT-3.5 may not effectively supplement patient-related information in the context of recommendations provided by the treating surgeon prior to rotator cuff repair surgery.

Antioxidants accelerate tendon-to-bone healing after rotator cuff repair surgery

Antioxidants accelerate tendon-to-bone healing after rotator cuff repair surgery

A novel 3D MRI-based approach for assessing supraspinatus muscle length

Rotator cuff (RC) tears are a common source of pain and decreased shoulder strength. Muscle length is known to affect muscle strength, and therefore evaluating changes in supraspinatus muscle length associated with RC pathology, surgical repair, and post-operative recovery may provide insights into functional deficits. Our objective was to develop a reliable MRI-based approach for assessing supraspinatus muscle length. Using a new semi-automated approach for identifying 3D location of the muscle–tendon junction (MTJ), supraspinatus muscle length was calculated as the sum of MTJ distance (distance between 3D MTJ position and glenoid plane) and supraspinatus fossa length (distance between root of the scapular spine and glenoid plane). Inter- and intra-operator reliability of this technique were assessed with intraclass correlation coefficient (ICC) and found to be excellent (ICCs > 0.96). Muscle lengths of 6 patients were determined before RC repair surgery and at 3- and 12-months post-surgery. Changes in normalized muscle length (muscle length as a percentage of pre-surgical muscle length) at 3 months post-surgery varied considerably across patients (16.1 % increase to 7.0 % decrease) but decreased in all patients from 3- to 12-months post-surgery (0.3 % to 17.2 %). This study developed a novel and reliable approach for quantifying supraspinatus muscle length and provided preliminary demonstration of its utility by assessing muscle length changes associated with RC pathology and surgical repair. Future studies can use this technique to evaluate changes over time in supraspinatus muscle length in response to clinical intervention, and associations between muscle length and shoulder function.

Sleep disturbances in rotator cuff pathology: insights into mechanisms and clinical implications.

Rotator cuff disease is highly prevalent and can have a detrimental effect on the quality of life of affected patients. One of the most common complaints from rotator cuff disease is sleep disturbance due to shoulder pain. Numerous studies have attempted to explore the relationship between rotator cuff disease and sleep disturbance, but results are inconsistent and limited. In this setting, the Pittsburgh Sleep Quality Index (PSQI) plays an important role in preoperative assessment and evaluation of sleep in rotator cuff patients. However, despite the current efforts, the literature presents conflicting results regarding the relationships between magnetic resonance imaging characteristics of rotator cuff tear and PSQI score, signifying a gap in understanding. That being said, it has been shown that rotator cuff repair surgery can alleviate sleep disturbances witnessed preoperatively in and can restore quality of life.

Surgeon Factors and Trends Associated With the Use of Subacromial Decompression at the Time of Rotator Cuff Repair

Subacromial decompression (SAD) has historically been described as an essential part of the surgical treatment of rotator cuff disorders. However, investigations throughout the 21st century have increasingly questioned the need for routine SAD during rotator cuff repair (RCR). Our purpose was to assess for changes in the incidence of SAD performed during RCR over a 12-year period. In addition, we aimed to characterize surgeon and practice factors associated with SAD use. Records from two large tertiary referral systems in the United States from 2010 to 2021 were reviewed. All cases of RCR with and without SAD were identified. The outcome of interest was the proportion of SAD performed during RCR across years and by surgeon. Surgeon-specific characteristics included institution, fellowship training, surgical volume, academic practice, and years in practice. Yearly trends were assessed using binomial logistic regression modeling, with a random effect accounting for surgeon-specific variability. During the study period, 37,165 RCR surgeries were performed by 104 surgeons. Of these cases, 71% underwent SAD during RCR. SAD use decreased by 11%. The multivariable model found that surgeons in academic practice, those with lower surgical volume, and those with increasing years in practice were significantly associated with increased odds of performing SAD. Surgeons with fellowship training were significantly more likely to use SAD over time, with the greatest odds of SAD noted for sports medicine surgeons (odds ratio= 3.04). Although SAD use during RCR appears to be decreasing, multiple surgeon and practice factors (years in practice, fellowship training, volume, and academic practice) are associated with a change in SAD use. These data suggest that early-career surgeons entering practice are likely driving the trend of declining SAD. Despite evidence suggesting limited clinical benefits, SAD remains commonly performed; future studies should endeavor to determine factors associated with practice changes among surgeons.

Fixation technique of biodegradable magnesium alloy suture anchor in the rotator cuff repair of the shoulder in a goat model: a technical note

BackgroundShoulder disorders, particularly rotator cuff tears, are prevalent musculoskeletal conditions related to aging. Although the widely used suture anchor technique provides strong mechanical support to the tendon, it is associated with a risk of postoperative tendon retearing. The conventionally used titanium alloys can affect the interpretation of magnetic resonance imaging. Degradable magnesium alloys possess excellent biocompatibility, similar mechanical property to the bone, and stimulating bone formation ability from Mg2+. The purpose of this experiment was to develop innovative magnesium-based suture anchors to enhance rotator cuff repair by improving fixation materials, and to evaluate their feasibility in a goat model.MethodsWe developed fluoridized ZK60 suture anchors as the implantation material for two goats, who underwent rotator cuff repair surgery on both shoulders. Computed tomography (CT) and histological analysis were performed at 12 weeks postoperatively, and the results were compared between the magnesium and titanium alloy groups. Additionally, a hematological examination was conducted, which included assessments of red blood cells, white blood cells, platelets, coagulation function, liver function, kidney function, and magnesium ion concentration.ResultsThe 12-week postoperative CT images showed intact MgF2 ZK60 suture anchors, effectively reconnecting the infraspinatus tendon to the humeral head. The anchors became less visible on CT scans, indicating absorption by surrounding tissues. New bone formation in the MgF2 group surpassed that in the Ti group, demonstrating superior osseointegration. The similarity between cortical bone and magnesium reduced stress-shielding and promoted bone regeneration. Histological analysis revealed successful tendon healing with MgF2 anchors, while the Ti group showed discontinuous interfaces and reduced collagen secretion. Hematological examination showed stable liver, renal function, and magnesium ion levels.ConclusionsThe findings indicate that MgF2-coated suture anchors are feasible for rotator cuff repair and potentially other orthopedic applications. We hope that magnesium alloy anchors can become the solution for rotator cuff tendon repair surgery.

The impact of social deprivation on healthcare utilization patterns following rotator cuff repair

BackgroundDisparities in social determinants of health have been linked to worse patient reported outcomes, higher pain, and increased risk of revision surgery following rotator cuff repair. Identification of perioperative predictors of increased healthcare utilization is of particular interest to surgeons to improve outcomes and mitigate the total cost of care. The effect of social deprivation on healthcare utilization has not been fully characterized. MethodsThis is a retrospective review of a single institution's experience with primary rotator cuff repair between 2012-2020. Demographic variables (age, race, gender, ASA score) and healthcare utilization (hospital readmission, emergency department visits, follow-up visits, telephone calls) were recorded within 90 days of surgery. The Area Deprivation Index (ADI) was recorded, and patients were separated into terciles according to their relative level of social deprivation. Outcomes were then stratified based on ADI tercile and compared. ResultsA total of 1695 patients were included. The upper, middle, and lower terciles of ADI consisted of 410, 767, and 518 patients, respectively. The most deprived tercile had greater emergency department visitation and office visitation within 90 days of surgery relative to the least and intermediate deprived terciles. Higher levels of social deprivation were independent risk factors for increased ED visitation and follow-up visitation. There was no difference in 90-day readmission rates or telephone calls made between the least, intermediate, and most deprived patients. ConclusionsPatients with higher levels of deprivation demonstrated greater postoperative hospital utilization. We hope to use these results to identify risk factors for increased hospital use, guide clinical decision making, increase transparency, and manage patient outcomes following rotator cuff repair surgery.