Rotator cuff repair in patients with inflammatory arthritis: satisfactory midterm outcomes

Daniel C Austin; Ryan R Wilbur; Thomas H Rogers; Jonathan D Barlow; Christopher L Camp; Mark E Morrey; John W Sperling; Joaquin Sanchez-Sotelo

doi:10.1016/j.jseint.2022.08.019

Rotator cuff repair in patients with inflammatory arthritis: satisfactory midterm outcomes

JSES Int. 2022 Sep 19;7(1):30-34. doi: 10.1016/j.jseint.2022.08.019. eCollection 2023 Jan.

Authors

Daniel C Austin¹, Ryan R Wilbur¹, Thomas H Rogers¹, Jonathan D Barlow¹, Christopher L Camp¹, Mark E Morrey¹, John W Sperling¹, Joaquin Sanchez-Sotelo¹

Affiliation

¹ Orthopedic Department, Mayo Clinic, Rochester, MN, USA.

Abstract

Background: We aimed to evaluate midterm patient-reported outcomes and reoperation rates following rotator cuff repair in patients with either rheumatoid arthritis (RA) or other inflammatory arthritis (nonRA-IA) diagnoses.

Methods: We identified all patients with either RA or nonRA-IA who underwent a rotator cuff repair at our institution between 2008 and 2018. IA diagnoses included RA, systemic lupus erythematosus, psoriatic arthritis, and other unspecified inflammatory arthritis. We compiled a cohort of 51 shoulders, with an average follow-up time of 7.0 years. The average age was 60 years (range 39-81), and 55% of patients were female. Patients were contacted via phone to obtain patient-reported outcomes surveys. Univariate linear regression was used to evaluate associations between patient characteristics and outcomes.

Results: A review of preoperative radiographs demonstrated that 50% of patients presented with some degree of glenohumeral joint inflammatory degeneration. At the final follow-up, the mean visual analog score for pain was 2 (range 0-8), and the mean American Shoulder and Elbow Surgeons score (ASES) was 77 (standard deviation [SD] = 19). The mean subjective shoulder value was 75% (SD = 22%), and the average satisfaction was 9 (SD 1.9). The mean Patient-Reported Outcomes Measurement Information System upper extremity score was 41 (SD = 10.6). Female sex and a complete tear (vs. partial) were both associated with lower ASES scores, whereas no other characteristics were associated with postoperative ASES scores. The 5-year Kaplan-Meier survival estimate free of reoperation was 91.8% (95% confidence interval 83.0-99.8).

Conclusions: Rotator cuff repair in patients with RA or other inflammatory arthritis diagnoses resulted in satisfactory patient-reported outcomes that seem comparable to rotator cuff repair when performed in the general population. Furthermore, reoperations were rare, with a 5-year survival rate free of reoperation for any reason of over 90%. Altogether, an inflammatory arthritis diagnosis should not preclude by itself attempted rotator cuff repair surgery in these patients.

Keywords: Inflammatory arthritis; Outcomes; RA; Rheumatoid arthritis; Rotator cuff repair; nonRA-IA.