PMID- 31696133 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220411 IS - 2325-9671 (Print) IS - 2325-9671 (Electronic) IS - 2325-9671 (Linking) VI - 7 IP - 10 DP - 2019 Oct TI - Preoperative Mental Health Scores and Achieving Patient Acceptable Symptom State Are Predictive of Return to Work After Arthroscopic Rotator Cuff Repair. PG - 2325967119878415 LID - 10.1177/2325967119878415 [doi] LID - 2325967119878415 AB - BACKGROUND: The incidence of rotator cuff repairs has risen dramatically over the past 10 years, most notably in the working-class population. Return to work (RTW) is a valuable outcome measure to set patient expectations before surgery. PURPOSE: To establish the rate of RTW after rotator cuff repair with respect to stratified levels of occupational demand (sedentary, light, moderate, and heavy) and to identify clinical factors significantly associated with postoperative RTW. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients who received rotator cuff repair between 2014 and 2017 were queried from a prospectively maintained institutional registry. Work status was evaluated from clinical and physical therapy notes, and RTW was stratified based on duty level. The minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) values were calculated for American Shoulder and Elbow Surgeons (ASES) score and subjective Constant score through use of an anchor-based approach. Patient demographic factors, preoperative ASES scores, Constant scores, and health-related quality of life scores, as well as change in postoperative scores exceeding the thresholds for MCID, SCB, and PASS, were analyzed to determine significant associations with RTW without restriction. RESULTS: In total, 89 patients with documented pre- and postoperative work status underwent surgery. Rates of RTW for sedentary, light, moderate, and heavy duties were 100%, 84.0%, 77.4%, and 63.3%, respectively, within return at less than 7 postoperative months on average. RTW was associated with achieving PASS (P = .004) but not achieving MCID and SCB (P = .429 and .452, respectively). Injury to a patient's dominant side had reduced odds (0.057; 95% CI, 0.004-0.763; P = .030) for RTW at full duty. Tear characteristics and type of insurance were not associated with RTW. Preoperative Veterans RAND Mental Component Score (>53.3; area under the curve, 70.4%) was predictive of returning to work. CONCLUSION: A vast majority of patients undergoing rotator cuff repair can expect to return to work within 8 months of surgery. Preoperative mental health scores can predict future return to work, which supports the concept that mental health status plays an important role in the outcomes after rotator cuff repair surgery. CI - (c) The Author(s) 2019. FAU - Gowd, Anirudh K AU - Gowd AK AD - Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA. FAU - Cvetanovich, Gregory L AU - Cvetanovich GL AD - The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. FAU - Liu, Joseph N AU - Liu JN AD - Loma Linda University Medical Center, Loma Linda, California, USA. FAU - Nwachukwu, Benedict U AU - Nwachukwu BU AD - Hospital for Special Surgery, New York, New York, USA. FAU - Cabarcas, Brandon C AU - Cabarcas BC AD - University of South Florida Health, Tampa, Florida, USA. FAU - Cole, Brian J AU - Cole BJ AD - Rush University Medical Center, Chicago, Illinois, USA. FAU - Forsythe, Brian AU - Forsythe B AD - Rush University Medical Center, Chicago, Illinois, USA. FAU - Romeo, Anthony A AU - Romeo AA AD - Rush University Medical Center, Chicago, Illinois, USA. FAU - Verma, Nikhil N AU - Verma NN AD - Rush University Medical Center, Chicago, Illinois, USA. LA - eng PT - Journal Article DEP - 20191029 PL - United States TA - Orthop J Sports Med JT - Orthopaedic journal of sports medicine JID - 101620522 PMC - PMC6820363 OTO - NOTNLM OT - minimal clinically important difference OT - patient acceptable symptom state OT - quality-based care OT - return to work OT - rotator cuff repair OT - substantial clinical benefit COIS- One or more of the authors has declared the following potential conflict of interest or source of funding: G.L.C. has received research support from Arthrex and educational support from Medwest and Smith & Nephew. J.N.L. has received educational support from Smith & Nephew. B.J.C. has received consulting fees from Arthrex, Genzyme, Pacira Pharmaceuticals, Anika Therapeutics, Geistlich Pharma, Vericel, Bioventus, Zimmer, and Smith & Nephew; educational support from Arthrex and Pacira Pharmaceuticals; royalties from Arthrex and DJO; nonconsulting fees from Arthrex, Carticept Medical, and LifeNet Health; and hospitality payments from Aesculap/B.Braun, DePuy, and GE Healthcare. B.F. has received consulting fees from Sonoma Orthopedics and Stryker, honorarium from Arthrosurface, and educational support from Medwest. A.A.R. has received consulting fees and royalties from Arthrex. N.N.V. has received consulting fees from Smith & Nephew and Medacta USA, royalties from Smith & Nephew, nonconsulting fees from Pacira Pharmaceuticals, educational support from Medwest, and hospitality payments from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. EDAT- 2019/11/07 06:00 MHDA- 2019/11/07 06:01 PMCR- 2019/10/29 CRDT- 2019/11/08 06:00 PHST- 2019/11/08 06:00 [entrez] PHST- 2019/11/07 06:00 [pubmed] PHST- 2019/11/07 06:01 [medline] PHST- 2019/10/29 00:00 [pmc-release] AID - 10.1177_2325967119878415 [pii] AID - 10.1177/2325967119878415 [doi] PST - epublish SO - Orthop J Sports Med. 2019 Oct 29;7(10):2325967119878415. doi: 10.1177/2325967119878415. eCollection 2019 Oct.