Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(03): 463-470
DOI: 10.1055/s-0042-1749206
Artigo Original
Ombro e Cotovelo

The Impact of COVID-19 on the Timing of Rotator Cuff Repair and Method of Postoperative Follow-up

Article in several languages: português | English
Kevin C. Wang 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
,
Liam R. Butler 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
,
Christopher A. White 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
,
Akshar V. Patel 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
,
Bradford O. Parsons 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
,
Paul J. Cagle 
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, NY, Estados Unidos
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective Rotator cuff repair (RCR) is one of the most common arthroscopic procedures. Our investigation aims to quantify the impact that the COVID-19 pandemic had on RCR, specifically on patients with acute, traumatic injuries.

Methods Institutional records were queried to identify patients who underwent arthroscopic RCR between March 1st to October 31st of both 2019 and 2020. Patient demographic, preoperative, perioperative, and postoperative data were collected from electronic medical records. Inferential statistics were used to analyze data.

Results Totals of 72 and of 60 patients were identified in 2019 and in 2020, respectively. Patients in 2019 experienced shorter lengths of time from MRI to surgery (62.7 ± 70.5 days versus 115.7 ± 151.0 days; p = 0.01). Magnetic resonance imaging (MRI) scans showed a smaller average degree of retraction in 2019 (2.1 ± 1.3 cm versus 2.6 ± 1.2 cm; p = 0.05) but no difference in anterior to posterior tear size between years (1.6 ± 1.0 cm versus 1.8 ± 1.0 cm; p = 0.17). Less patients in 2019 had a telehealth postoperative consultation with their operating surgeon compared with 2020 (0.0% versus 10.0%; p = 0.009). No significant changes in complications (0.0% versus 0.0%; p > 0.999), readmission (0.0% versus 0.0%; p > 0.999), or revision rates (5.6% versus 0.0%; p = 0.13) were observed.

Conclusion From 2019 to 2020, there were no significant differences in patient demographics or major comorbidities. Our data suggests that even though the time from MRI to surgery was delayed in 2020 and telemedicine appointments were necessary, RCR was still performed in a timely manner and with no significant changes in early complications.

Level of Evidence III.

Keywords

COVID-19 - operative time - perioperative period - rotator cuff - shoulder

Financial Support

The present study received no financial support from any public, commercial, or not-for-profit sources.


Work developed at the Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY.




Publication History

Received: 26 October 2021

Accepted: 28 March 2022

Article published online:
10 June 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Mall NA, Lee AS, Chahal J. et al. An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy 2013; 29 (02) 366-376
    CrossrefPubMedGoogle Scholar
  • 2 Subhash AK, Maldonado DR, Kajikawa TM, Chen SL, Stavrakis A, Photopoulos C. Public Interest in Sports Medicine and Surgery (Anterior Cruciate Ligament, Meniscus, Rotator Cuff) Topics Declined Following the COVID-19 Outbreak. Arthrosc Sports Med Rehabil 2021; 3 (01) e149-e154
    CrossrefPubMedGoogle Scholar
  • 3 Chang JS, Wignadasan W, Pradhan R, Kontoghiorghe C, Kayani B, Haddad FS. Elective orthopaedic surgery with a designated COVID-19-free pathway results in low perioperative viral transmission rates. Bone Jt Open 2020; 1 (09) 562-567
    CrossrefPubMedGoogle Scholar
  • 4 Moverman MA, Puzzitiello RN, Pagani NR, Barnes CL, Jawa A, Menendez ME. Public Perceptions of Resuming Elective Surgery During the COVID-19 Pandemic. J Arthroplasty 2021; 36 (02) 397-402.e2
    CrossrefPubMedGoogle Scholar
  • 5 Fitzgerald MJ, Goodman HJ, Kenan S, Kenan S. Did COVID-19 related delays in surgical management lead to patient morbidity in the orthopaedic oncological population?. Bone Jt Open 2021; 2 (04) 236-242
    CrossrefPubMedGoogle Scholar
  • 6 Lockey SD, Nelson PC, Kessler MJ, Kessler MW. Approaching “Elective” Surgery in the Era of COVID-19. J Hand Surg Am 2021; 46 (01) 60-64
    CrossrefPubMedGoogle Scholar
  • 7 Duncan NS, Booker SJ, Gooding BW, Geoghegan J, Wallace WA, Manning PA. Surgery within 6 months of an acute rotator cuff tear significantly improves outcome. J Shoulder Elbow Surg 2015; 24 (12) 1876-1880
    CrossrefPubMedGoogle Scholar
  • 8 Fu MC, O'Donnell EA, Taylor SA. et al. Delay to Arthroscopic Rotator Cuff Repair Is Associated With Increased Risk of Revision Rotator Cuff Surgery. Orthopedics 2020; 43 (06) 340-344
    CrossrefPubMedGoogle Scholar
  • 9 Patel V, Thomas C, Fort H. et al. Early versus delayed repair of traumatic rotator cuff tears. Does timing matter on outcomes?. Eur J Orthop Surg Traumatol 2022; 32 (02) 269-277
    CrossrefPubMedGoogle Scholar
  • 10 Petersen SA, Murphy TP. The timing of rotator cuff repair for the restoration of function. J Shoulder Elbow Surg 2011; 20 (01) 62-68
    CrossrefPubMedGoogle Scholar
  • 11 Hinckel BB, Baumann CA, Ejnisman L. et al. Evidence-based Risk Stratification for Sport Medicine Procedures During the COVID-19 Pandemic. J Am Acad Orthop Surg Glob Res Rev 2020; 4 (10) 00083
    Google Scholar
  • 12 Humbyrd CJ, Dunham AM, Xu AL, Rieder TN. Restarting Orthopaedic Care in a Pandemic: Ethical Framework and Case Examples. J Am Acad Orthop Surg 2021; 29 (02) e72-e78
    CrossrefPubMedGoogle Scholar
  • 13 Kwong CA, Ono Y, Carroll MJ. et al. Full-Thickness Rotator Cuff Tears: What Is the Rate of Tear Progression? A Systematic Review. Arthroscopy 2019; 35 (01) 228-234
    CrossrefPubMedGoogle Scholar
  • 14 Bockmann B, Venjakob AJ, Holschen M, Nebelung W, Schulte TL. Elective shoulder surgery during the coronavirus disease 2019 pandemic in Germany: the patients' perspective. JSES Int 2021; 5 (03) 342-345
    CrossrefPubMedGoogle Scholar
  • 15 Spross C, Behrens G, Dietrich TJ. et al. Early Arthroscopic Repair of Acute Traumatic Massive Rotator Cuff Tears Leads to Reliable Reversal of Pseudoparesis: Clinical and Radiographic Outcome. Arthroscopy 2019; 35 (02) 343-350
    CrossrefPubMedGoogle Scholar
  • 16 Sabbagh R, Shah N, Jenkins S. et al. The COVID-19 pandemic and follow-up for shoulder surgery: The impact of a shift toward telemedicine on validated patient-reported outcomes. J Telemed Telecare 2021; x: X21990997
    Google Scholar
  • 17 Menendez ME, Jawa A, Haas DA, Warner JJP. Codman Shoulder Society. Orthopedic surgery post COVID-19: an opportunity for innovation and transformation. J Shoulder Elbow Surg 2020; 29 (06) 1083-1086
    CrossrefPubMedGoogle Scholar