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Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair

BACKGROUND: Rotator cuff repair is one of the most common surgical procedures performed on the shoulder. Previous studies have indicated that pain and disability can vary significantly between patients with similarly appearing rotator cuff tears on diagnostic imaging. Prior literature has compared f...

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Autores principales: Daniels, Stephen D., Stewart, Cory M., Garvey, Kirsten D., Brook, Emily M., Higgins, Laurence D., Matzkin, Elizabeth G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878615/
https://www.ncbi.nlm.nih.gov/pubmed/31803785
http://dx.doi.org/10.1177/2325967119881959
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author Daniels, Stephen D.
Stewart, Cory M.
Garvey, Kirsten D.
Brook, Emily M.
Higgins, Laurence D.
Matzkin, Elizabeth G.
author_facet Daniels, Stephen D.
Stewart, Cory M.
Garvey, Kirsten D.
Brook, Emily M.
Higgins, Laurence D.
Matzkin, Elizabeth G.
author_sort Daniels, Stephen D.
collection PubMed
description BACKGROUND: Rotator cuff repair is one of the most common surgical procedures performed on the shoulder. Previous studies have indicated that pain and disability can vary significantly between patients with similarly appearing rotator cuff tears on diagnostic imaging. Prior literature has compared functional outcomes between operative and nonoperative treatments as well as variability in surgical techniques. However, few studies have examined postoperative outcomes based on patient factors such as sex. PURPOSE: To compare patient-reported outcomes after rotator cuff repair between men and women. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 283 patients (153 male, 130 female) who underwent primary arthroscopic rotator cuff repair were included in this study; of those, 275 patients (97.2%) completed 1-year follow-up. Patient-reported pain visual analog scale (VAS), Veterans RAND 12-item Health Survey (VR-12 mental and physical components), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numeric Evaluation (SANE) scores were collected preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively using an electronic outcomes system. RESULTS: Women reported higher VAS pain scores when compared with men preoperatively (P < .01) and at 2 weeks (P < .01), 6 weeks (P < .01), and 3 months (P = .02) postoperatively. Additionally, women experienced a greater overall change in the mean VAS score preoperatively when compared with 1 year postoperatively (P < .01). The use of narcotic pain medication 2 weeks after surgery was greater in women (P = .032). Women had significantly lower preoperative VR-12 mental scores (P = .03) and experienced a greater increase in the mean VR-12 mental score preoperatively when compared with 1 year postoperatively (P < .01). Men had higher ASES scores preoperatively (P < .01) and at 3 months postoperatively (P < .01). Women experienced a greater overall change in the ASES score preoperatively when compared with 1 year postoperatively (P < .01). CONCLUSION: Women reported greater pain and decreased shoulder function compared with men during the initial 3 months after arthroscopic rotator cuff repair. There were no sex-based differences in patient-reported outcomes at 1-year follow-up. The results of this study indicate that there are sex-related differences in the early postoperative recovery of patients undergoing rotator cuff repair, contributing to postoperative expectations for both clinicians and patients alike.
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spelling pubmed-68786152019-12-04 Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair Daniels, Stephen D. Stewart, Cory M. Garvey, Kirsten D. Brook, Emily M. Higgins, Laurence D. Matzkin, Elizabeth G. Orthop J Sports Med Article BACKGROUND: Rotator cuff repair is one of the most common surgical procedures performed on the shoulder. Previous studies have indicated that pain and disability can vary significantly between patients with similarly appearing rotator cuff tears on diagnostic imaging. Prior literature has compared functional outcomes between operative and nonoperative treatments as well as variability in surgical techniques. However, few studies have examined postoperative outcomes based on patient factors such as sex. PURPOSE: To compare patient-reported outcomes after rotator cuff repair between men and women. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 283 patients (153 male, 130 female) who underwent primary arthroscopic rotator cuff repair were included in this study; of those, 275 patients (97.2%) completed 1-year follow-up. Patient-reported pain visual analog scale (VAS), Veterans RAND 12-item Health Survey (VR-12 mental and physical components), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numeric Evaluation (SANE) scores were collected preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively using an electronic outcomes system. RESULTS: Women reported higher VAS pain scores when compared with men preoperatively (P < .01) and at 2 weeks (P < .01), 6 weeks (P < .01), and 3 months (P = .02) postoperatively. Additionally, women experienced a greater overall change in the mean VAS score preoperatively when compared with 1 year postoperatively (P < .01). The use of narcotic pain medication 2 weeks after surgery was greater in women (P = .032). Women had significantly lower preoperative VR-12 mental scores (P = .03) and experienced a greater increase in the mean VR-12 mental score preoperatively when compared with 1 year postoperatively (P < .01). Men had higher ASES scores preoperatively (P < .01) and at 3 months postoperatively (P < .01). Women experienced a greater overall change in the ASES score preoperatively when compared with 1 year postoperatively (P < .01). CONCLUSION: Women reported greater pain and decreased shoulder function compared with men during the initial 3 months after arthroscopic rotator cuff repair. There were no sex-based differences in patient-reported outcomes at 1-year follow-up. The results of this study indicate that there are sex-related differences in the early postoperative recovery of patients undergoing rotator cuff repair, contributing to postoperative expectations for both clinicians and patients alike. SAGE Publications 2019-11-25 /pmc/articles/PMC6878615/ /pubmed/31803785 http://dx.doi.org/10.1177/2325967119881959 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Daniels, Stephen D.
Stewart, Cory M.
Garvey, Kirsten D.
Brook, Emily M.
Higgins, Laurence D.
Matzkin, Elizabeth G.
Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title_full Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title_fullStr Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title_full_unstemmed Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title_short Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair
title_sort sex-based differences in patient-reported outcomes after arthroscopic rotator cuff repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878615/
https://www.ncbi.nlm.nih.gov/pubmed/31803785
http://dx.doi.org/10.1177/2325967119881959
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