One-year patient-reported outcomes following primary arthroscopic rotator cuff repair vary little by surgeon

• Published in: JSES International
• Main Authors: Sambit Sahoo, MBBS, PhD, Kathleen A. Derwin, PhD, Yuxuan Jin, MS, Peter B. Imrey, PhD, Eric T. Ricchetti, MD, Vahid Entezari, MD, MMSc, Joseph P. Iannotti, MD, PhD, Kurt P. Spindler, MD, Jason C. Ho, MD, Peter J. Evans, Lutul D. Farrow, Gregory J. Gilot, Anthony A. Miniaci, Mark S. Schickendantz, William H. Seitz, Alfred Serna, Kim L. Stearns, Greg Strnad
• Format: Article
• Language: English
• Published: Elsevier 2023-07-01
• Subjects: Shoulder; Surgeon performance; Rotator cuff repair; PROMs; PENN shoulder score; Preoperative factors
• Online Access: http://www.sciencedirect.com/science/article/pii/S2666638323000737

Background: This study’s purpose was to investigate the extent to which differences among operating surgeons may influence 1-year patient-reported outcome measures (PROMs) in patients undergoing rotator cuff repair (RCR) surgery, after controlling for general and disease-specific patient factors. We hypothesized that surgeon would be additionally associated with 1-year PROMs, specifically the baseline to 1-year improvement in Penn Shoulder Score (PSS). Methods: We used mixed multivariable statistical modeling to assess the influence of surgeon (and alternatively surgical case volume) on 1-year PSS improvement in patients undergoing RCR at a single health system in 2018, controlling for eight patient- and six disease-specific preoperative factors as possible confounders. Contributions of predictors to explaining variation in 1-year PSS improvement were measured and compared using Akaike’s Information Criterion. Results: 518 cases performed by 28 surgeons met inclusion criteria, with median (quartiles) baseline PSS of 41.9 (31.9, 53.9) and 1-year PSS improvement of 42 (29.1, 55.3) points. Contrary to expectation, surgeon and surgical case volume were neither statistically significantly nor clinically meaningfully associated with 1-year PSS improvement. Baseline PSS and mental health status (VR-12 MCS) were the dominant and only statistically significant predictors of 1-year PSS improvement, with lower baseline PSS and higher VR-12 MCS predicting larger 1-year PSS improvement. Conclusion: Patients generally reported excellent 1-year outcomes following primary RCR. This study did not find evidence that the individual surgeon or surgeon case volume influences 1-year PROMs, independently of case-mix factors, following primary RCR in a large employed hospital system.