Day M, et al. - This study entailed comparison between arthroscopic and open rotator cuff repair (RTCR), in terms of the incidence and risk factors for short-term complications after repair. Researchers also identified independent risk factors for complications after RTCR. They noted that short-term complications after RTCR were rare. As reported in propensity-matched patient groups and in multivariate analysis, open RTCR carried higher post-procedural total complications. Patient age >65, operative time >90 minutes, and open repair were identified as risk factors for complications. Open RTCR was shown to be associated with an increased risk of surgical infections.

Methods

• Using the American College of Surgeons National Surgical Quality Improvement Program database, researchers identified all patients who underwent open or arthroscopic RTCR from 2005 to 2013.
• Categories of short-term complications were: surgical, medical, mortality, and unplanned 30-day readmission.
• They used univariate analysis to compare patient demographics and comorbidities.
• They used propensity score matching to control for demographic differences between arthroscopic and open RTCR patient groups.
• Furthermore, using multivariate logistic regression, they identified independent risk factors for complication.

Results

• This study included a total of 11,314 RTCRs (24% open, 76% arthroscopic).
• The mean operative time for open RTCR vs arthroscopic repairs was 78 minutes vs 91 minutes, respectively (P < .001).
• According to findings, the overall complication rate was 1.3%, with the highest complication unplanned return to the operating room (41 patients, 0.36%).
• Researchers noted that the 30-day readmission was 1.16% (76/6,560 patients) and the mortality rate was 0.03% (3 patients).
• They also observed that in the propensity-score-matched patient group, total 30-day complications were higher following open vs arthroscopic repair (1.79% vs 1.17%; P=.006).
• Results revealed that the overall infection rate after RTCR was 0.56%, the open repair patient group had higher deep wound infection (P=.003).
• As revealed by multivariate analysis, independent risk factors for complications included age >65 years (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.2-2.3), operative time >90 minutes (OR 1.5; CI 1.1-2.1), and open RTCR (OR 1.6; CI 1.1-2.3).