Return to Sports After Arthroscopic Rotator Cuff Repair in Recreational Athletes
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Published:
Aug 20, 2024
Keywords:
Shoulder, rotator cuff, return to sports, recreational sports
Main Article Content
Abstract
Objective: To assess return to sports in recreational athletes after arthroscopic rotator cuff repair (ARCR). Materials and Methods: Retrospective single-site study of recreational athletes who were operated on between August 2019 and December 2020 for ARCR, with a minimum follow-up of one year. Patients were divided into 2 groups based on their shoulder demand: high or low. The primary endpoint was return to sports. Secondary criteria included time to return, level achieved, pre and postoperative VAS for pain, and ASES and Constant scores. The minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were calculated. Complications were recorded.
Results: A total of 102 patients (mean age: 58.7 years) were included. Seventy patients practiced a sport with high shoulder involvement. The mean follow-up was 18 months. 82.3% of patients returned to recreational sports, with 63 participating at the same level. The median time to return was six months. Return to sports was 91% in the low-shoulder demand group versus 79% in the high-shoulder demand group. VAS, Constant and ASES scores improved after six and twelve months. For the ASES and Constant scores, 98 and 100% of patients met the MCID and SCB, respectively.A total of eight patients reported persistent pain. Five patients required revision surgery.
Conclusion: Most recreational athletes who undergo ARCR are able to resume their previous level of activity. Most athletes achieved significant clinical improvement with a low rate of complications (7.8%).
Results: A total of 102 patients (mean age: 58.7 years) were included. Seventy patients practiced a sport with high shoulder involvement. The mean follow-up was 18 months. 82.3% of patients returned to recreational sports, with 63 participating at the same level. The median time to return was six months. Return to sports was 91% in the low-shoulder demand group versus 79% in the high-shoulder demand group. VAS, Constant and ASES scores improved after six and twelve months. For the ASES and Constant scores, 98 and 100% of patients met the MCID and SCB, respectively.A total of eight patients reported persistent pain. Five patients required revision surgery.
Conclusion: Most recreational athletes who undergo ARCR are able to resume their previous level of activity. Most athletes achieved significant clinical improvement with a low rate of complications (7.8%).
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How to Cite
Gorodischer, T., Rossi, L. A., Tanoira, I., & Ranalletta , M. (2024). Return to Sports After Arthroscopic Rotator Cuff Repair in Recreational Athletes. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(4), 333-340. https://doi.org/10.15417/issn.1852-7434.2024.89.4.1829
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Clinical Research
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References
1. Teunis T, Lubberts B, Reilly BT, Ring D. A systematic review and pooled analysis of the prevalence of rotator cuff
disease with increasing age. J Shoulder Elbow Surg 2014;23(12):1913-21. https://doi.org/10.1016/j.jse.2014.08.001
2. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a
rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19(1):116-20. https://doi.org/10.1016/j.jse.2009.04.006
3. Ji X, Bi C, Wang F, Wang Q. Arthroscopic versus mini-open rotator cuff repair: An up-to-date meta-analysis of
randomized controlled trials. Arthroscopy 2015;31(1):118-24. https://doi.org/10.1016/j.arthro.2014.08.017
4. Baker CL, Liu SH. Comparison of open and arthroscopically assisted rotator cuff repairs. Am J Sports Med 1995;23(1):99-104. https://doi.org/10.1177/036354659502300117
5. Stenner BJ, Buckley JD, Mosewich AD. Reasons why older adults play sport: A systematic review. J Sport Health
Sci 2020;9(6):530-41. https://doi.org/10.1016/j.jshs.2019.11.003
6. Klouche S, Lefevre N, Herman S, Gerometta A, Bohu Y. Return to sport after rotator cuff tear repair: A systematic review and meta-analysis. Am J Sports Med 2016;44(7):1877-87. https://doi.org/10.1177/0363546515598995
7. Namdari S, Baldwin K, Ahn A, Russell Huffman G, Sennett BJ. Performance after rotator cuff tear and operative
treatment: A case-control study of major league baseball pitchers. J Athl Train 2011;46(3):296-302.
https://doi.org/10.4085/1062-6050-46.3.296
8. Harris JD, Frank JM, Jordan MA, Bush-Joseph CA, Romeo AA, Gupta AK, et al. Return to sport following shoulder
surgery in the elite pitcher: a systematic review. Sports Health 2013;5(4):367-76. https://doi.org/10.1177/1941738113482673
9. Mazoué CG, Andrews JR. Repair of full-thickness rotator cuff tears in professional baseball players. Am J Sports
Med 2006;34(2):182-9. https://doi.org/10.1177/0363546505279916
10. Altintas B, Anderson N, Dornan GJ, Boykin RE, Logan C, Millett PJ. Return to sport after arthroscopic rotator cuff repair: Is there a difference between the recreational and the competitive athlete? Am J Sports Med 2020;48(1):252-61. https://doi.org/10.1177/0363546519825624
11. Antoni M, Klouche S, Mas V, Ferrand M, Bauer T, Hardy P. Return to recreational sport and clinical outcomes with at least 2years follow-up after arthroscopic repair of rotator cuff tears. Orthop Traumatol Surg Res 2016;102(5):563-7. https://doi.org/10.1016/j.otsr.2016.02.015
12. Bhatia S, Greenspoon JA, Horan MP, Warth RJ, Millett PJ. Two-year outcomes after arthroscopic rotator cuff repair in recreational athletes older than 70 years. Am J Sports Med 2015;43(7):1737-42.
https://doi.org/10.1177/0363546515577623
13. Makhni EC, Steinhaus ME, Morrow ZS, Jobin CM, Verma NN, Cole BJ, et al. Outcomes assessment in rotator cuff pathology: what are we measuring? J Shoulder Elbow Surg 2015;24(12):2008-15. https://doi.org/10.1016/j.jse.2015.08.007
14. Katz NP, Paillard FC, Ekman E. Determining the clinical importance of treatment benefits for interventions for
painful orthopedic conditions. J Orthop Surg Res 2015;10:24. https://doi.org/10.1186/s13018-014-0144-x
15. Cvetanovich GL, Gowd AK, Liu JN, Nwachukwu BU, Cabarcas BC, Cole BJ, et al. Establishing clinically
significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 2019;28(5):939-48.
https://doi.org/10.1016/j.jse.2018.10.013
16. Azzam MG, Dugas JR, Andrews JR, Goldstein SR, Emblom BA, Cain EL Jr. Rotator cuff repair in adolescent
athletes. Am J Sports Med 2018;46(5):1084-90. https://doi.org/10.1177/0363546517752919
17. Dines JS, Jones K, Maher P, Altchek D. Arthroscopic management of full-thickness rotator cuff tears in major
league baseball pitchers: The lateralized footprint repair technique. Am J Orthop (Belle Mead NJ) 2016;45(3):128-
33. PMID: 26991564
18. Plate JF, Haubruck P, Walters J, Mannava S, Smith BP, Smith TL, et al. Rotator cuff injuries in professional and
recreational athletes. J Surg Orthop Adv 2013;22(2):134-42. https://doi.org/10.3113/jsoa.2013.0134
19. Kelly BC, Constantinescu DS, Pavlis W, Rap AR. Arthroscopic versus open rotator cuff repair: Fellowship-trained orthopaedic surgeons prefer arthroscopy and self-report a lower complication rate. Sports Med Arthrosc Rehabil Ther Technol 2021;3(6):e1865-e1871. https://doi.org/10.1016/j.asmr.2021.09.001
20. Wang KY, Agarwal AR, Xu AL, Best MJ, Kreulen RT, Jami M, et al. Increased risk of surgical-site infection and
need for manipulation under anesthesia for those who undergo open versus arthroscopic rotator cuff repair. Sports Med Arthrosc Rehabil Ther Technol 2022;4(2):e527-e533. https://doi.org/10.1016/j.asmr.2021.11.012
21. Kelly BC, Constantinescu DS, Vap AR. Arthroscopic and open or mini-open rotator cuff repair trends and
complication rates among American Board of Orthopaedic Surgeons Part II Examinees (2007-2017). Arthroscopy
2019;35(11):3019-24. https://doi.org/10.1016/j.arthro.2019.06.022
22. Yamaguchi K, Levine WN, Marra G, Galatz LM, Klepps S, Flatow EL. Transitioning to arthroscopic rotator cuff
repair: the pros and cons. Instr Course Lect 2003;52:81-92. PMID: 12690842
23. Dey Hazra R-O, Ernat JJ, Rakowski DR, Boykin RE, Millett PJ. The evolution of arthroscopic rotator cuff repair.
Orthop J Sports Med 2021;9(12):23259671211050899. https://doi.org/10.1177/23259671211050899
disease with increasing age. J Shoulder Elbow Surg 2014;23(12):1913-21. https://doi.org/10.1016/j.jse.2014.08.001
2. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a
rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19(1):116-20. https://doi.org/10.1016/j.jse.2009.04.006
3. Ji X, Bi C, Wang F, Wang Q. Arthroscopic versus mini-open rotator cuff repair: An up-to-date meta-analysis of
randomized controlled trials. Arthroscopy 2015;31(1):118-24. https://doi.org/10.1016/j.arthro.2014.08.017
4. Baker CL, Liu SH. Comparison of open and arthroscopically assisted rotator cuff repairs. Am J Sports Med 1995;23(1):99-104. https://doi.org/10.1177/036354659502300117
5. Stenner BJ, Buckley JD, Mosewich AD. Reasons why older adults play sport: A systematic review. J Sport Health
Sci 2020;9(6):530-41. https://doi.org/10.1016/j.jshs.2019.11.003
6. Klouche S, Lefevre N, Herman S, Gerometta A, Bohu Y. Return to sport after rotator cuff tear repair: A systematic review and meta-analysis. Am J Sports Med 2016;44(7):1877-87. https://doi.org/10.1177/0363546515598995
7. Namdari S, Baldwin K, Ahn A, Russell Huffman G, Sennett BJ. Performance after rotator cuff tear and operative
treatment: A case-control study of major league baseball pitchers. J Athl Train 2011;46(3):296-302.
https://doi.org/10.4085/1062-6050-46.3.296
8. Harris JD, Frank JM, Jordan MA, Bush-Joseph CA, Romeo AA, Gupta AK, et al. Return to sport following shoulder
surgery in the elite pitcher: a systematic review. Sports Health 2013;5(4):367-76. https://doi.org/10.1177/1941738113482673
9. Mazoué CG, Andrews JR. Repair of full-thickness rotator cuff tears in professional baseball players. Am J Sports
Med 2006;34(2):182-9. https://doi.org/10.1177/0363546505279916
10. Altintas B, Anderson N, Dornan GJ, Boykin RE, Logan C, Millett PJ. Return to sport after arthroscopic rotator cuff repair: Is there a difference between the recreational and the competitive athlete? Am J Sports Med 2020;48(1):252-61. https://doi.org/10.1177/0363546519825624
11. Antoni M, Klouche S, Mas V, Ferrand M, Bauer T, Hardy P. Return to recreational sport and clinical outcomes with at least 2years follow-up after arthroscopic repair of rotator cuff tears. Orthop Traumatol Surg Res 2016;102(5):563-7. https://doi.org/10.1016/j.otsr.2016.02.015
12. Bhatia S, Greenspoon JA, Horan MP, Warth RJ, Millett PJ. Two-year outcomes after arthroscopic rotator cuff repair in recreational athletes older than 70 years. Am J Sports Med 2015;43(7):1737-42.
https://doi.org/10.1177/0363546515577623
13. Makhni EC, Steinhaus ME, Morrow ZS, Jobin CM, Verma NN, Cole BJ, et al. Outcomes assessment in rotator cuff pathology: what are we measuring? J Shoulder Elbow Surg 2015;24(12):2008-15. https://doi.org/10.1016/j.jse.2015.08.007
14. Katz NP, Paillard FC, Ekman E. Determining the clinical importance of treatment benefits for interventions for
painful orthopedic conditions. J Orthop Surg Res 2015;10:24. https://doi.org/10.1186/s13018-014-0144-x
15. Cvetanovich GL, Gowd AK, Liu JN, Nwachukwu BU, Cabarcas BC, Cole BJ, et al. Establishing clinically
significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 2019;28(5):939-48.
https://doi.org/10.1016/j.jse.2018.10.013
16. Azzam MG, Dugas JR, Andrews JR, Goldstein SR, Emblom BA, Cain EL Jr. Rotator cuff repair in adolescent
athletes. Am J Sports Med 2018;46(5):1084-90. https://doi.org/10.1177/0363546517752919
17. Dines JS, Jones K, Maher P, Altchek D. Arthroscopic management of full-thickness rotator cuff tears in major
league baseball pitchers: The lateralized footprint repair technique. Am J Orthop (Belle Mead NJ) 2016;45(3):128-
33. PMID: 26991564
18. Plate JF, Haubruck P, Walters J, Mannava S, Smith BP, Smith TL, et al. Rotator cuff injuries in professional and
recreational athletes. J Surg Orthop Adv 2013;22(2):134-42. https://doi.org/10.3113/jsoa.2013.0134
19. Kelly BC, Constantinescu DS, Pavlis W, Rap AR. Arthroscopic versus open rotator cuff repair: Fellowship-trained orthopaedic surgeons prefer arthroscopy and self-report a lower complication rate. Sports Med Arthrosc Rehabil Ther Technol 2021;3(6):e1865-e1871. https://doi.org/10.1016/j.asmr.2021.09.001
20. Wang KY, Agarwal AR, Xu AL, Best MJ, Kreulen RT, Jami M, et al. Increased risk of surgical-site infection and
need for manipulation under anesthesia for those who undergo open versus arthroscopic rotator cuff repair. Sports Med Arthrosc Rehabil Ther Technol 2022;4(2):e527-e533. https://doi.org/10.1016/j.asmr.2021.11.012
21. Kelly BC, Constantinescu DS, Vap AR. Arthroscopic and open or mini-open rotator cuff repair trends and
complication rates among American Board of Orthopaedic Surgeons Part II Examinees (2007-2017). Arthroscopy
2019;35(11):3019-24. https://doi.org/10.1016/j.arthro.2019.06.022
22. Yamaguchi K, Levine WN, Marra G, Galatz LM, Klepps S, Flatow EL. Transitioning to arthroscopic rotator cuff
repair: the pros and cons. Instr Course Lect 2003;52:81-92. PMID: 12690842
23. Dey Hazra R-O, Ernat JJ, Rakowski DR, Boykin RE, Millett PJ. The evolution of arthroscopic rotator cuff repair.
Orthop J Sports Med 2021;9(12):23259671211050899. https://doi.org/10.1177/23259671211050899