PMID- 32835815
OWN - NLM
STAT- MEDLINE
DCOM- 20210604
LR  - 20210604
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 37
IP  - 1
DP  - 2021 Jan
TI  - Complications Within 6 Months After Arthroscopic Rotator Cuff Repair: 
      Registry-Based Evaluation According to a Core Event Set and Severity Grading.
PG  - 50-58
LID - S0749-8063(20)30688-5 [pii]
LID - 10.1016/j.arthro.2020.08.010 [doi]
AB  - PURPOSE: To report complications after arthroscopic rotator cuff repairs (ARCRs) 
      in a large patient cohort based on clinical application of a newly defined core 
      event set (CES) and severity grading. METHODS: Consecutive primary ARCRs 
      documented in a local clinical registry between February 2010 and September 2016 
      were included. Clinicians documented adverse events (AEs) reported until the 
      final, 6-month postoperative follow-up according to the CES. The CES is an 
      organized list of relevant AEs sorted into 3 intraoperative event groups (device, 
      osteochondral, and soft tissue) and 9 postoperative event groups (device, 
      osteochondral, pain, rotator cuff, surgical-site infection, peripheral 
      neurologic, vascular, superficial soft tissue, and deep soft tissue). Severity 
      was determined using an adaptation of the Clavien-Dindo classification. 
      Cumulative complication risks were calculated per event group and stratified by 
      severity and rotator cuff tear extent. RESULTS: A total of 1,661 repairs were 
      documented in 1,594 patients (mean age, 57 years [standard deviation, 9 years]; 
      38% women); 21% involved partial tears. All events were recorded according to the 
      CES. Intraoperative events occurred in 2.2% of repairs. We identified 329 
      postoperative events in 307 repairs (305 patients); 93% had 1 AE. The cumulative 
      AE risk at 6 months was 18.5%; AE risks were 21.8% for partial tears, 15.8% for 
      full-thickness single-tendon tears, 18.0% for tears with 2 ruptured tendons, and 
      25.6% for tears with 3 ruptured tendons. AE risks per event group were as 
      follows: 9.4% for deep soft tissue, with shoulder stiffness (7.6%) being the most 
      common event; 3.4% for persistent or worsening pain; 3.1% for rotator cuff 
      defects; 1.7% for neurologic lesions; 0.8% for surgical-site infection; 0.7% for 
      device; 0.4% for osteochondral; 0.2% for superficial soft tissue, and 0.1% for 
      vascular. Most AEs had severity grades I (160 [49%]) and II (117 [36%]). 
      CONCLUSIONS: Comprehensive local AE documentation according to the CES and 
      severity grading was possible and showed that about one-fifth of ARCRs were 
      affected, mostly by one AE of low severity. Shoulder stiffness was the most 
      frequent event. LEVEL OF EVIDENCE: Level IV, case series.
CI  - Copyright (c) 2020 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Felsch, Quinten
AU  - Felsch Q
AD  - Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland.
FAU - Mai, Victoria
AU  - Mai V
AD  - Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland.
FAU - Durchholz, Holger
AU  - Durchholz H
AD  - Research and Development, Schulthess Klinik, Zurich, Switzerland; Klinik Gut, St 
      Moritz, Switzerland.
FAU - Flury, Matthias
AU  - Flury M
AD  - Center for Orthopedics & Neurosurgery, In-Motion, Wallisellen, Switzerland.
FAU - Lenz, Maximilian
AU  - Lenz M
AD  - Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland.
FAU - Capellen, Carl
AU  - Capellen C
AD  - Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland.
FAU - Audige, Laurent
AU  - Audige L
AD  - Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland; Research and 
      Development, Schulthess Klinik, Zurich, Switzerland; Department of Orthopaedic 
      Surgery and Traumatology, University Hospital of Basel, Basel, Switzerland. 
      Electronic address: laurent.audige@kws.ch.
LA  - eng
PT  - Journal Article
DEP - 20200822
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2021 Jan;37(1):59-60. PMID: 33384097
MH  - Adult
MH  - Aged
MH  - Arthroscopy/*adverse effects
MH  - Female
MH  - Humans
MH  - Joint Diseases/etiology
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*etiology
MH  - Postoperative Period
MH  - Registries
MH  - Retrospective Studies
MH  - Risk
MH  - Rotator Cuff/*surgery
MH  - Rotator Cuff Injuries/*surgery
MH  - Severity of Illness Index
MH  - Tendon Injuries/*etiology
MH  - Treatment Outcome
EDAT- 2020/08/25 06:00
MHDA- 2021/06/05 06:00
CRDT- 2020/08/25 06:00
PHST- 2020/02/07 00:00 [received]
PHST- 2020/08/13 00:00 [revised]
PHST- 2020/08/13 00:00 [accepted]
PHST- 2020/08/25 06:00 [pubmed]
PHST- 2021/06/05 06:00 [medline]
PHST- 2020/08/25 06:00 [entrez]
AID - S0749-8063(20)30688-5 [pii]
AID - 10.1016/j.arthro.2020.08.010 [doi]
PST - ppublish
SO  - Arthroscopy. 2021 Jan;37(1):50-58. doi: 10.1016/j.arthro.2020.08.010. Epub 2020 
      Aug 22.