Issue:
A major issue in the Canadian health care system is the extensive wait times for consultation with an orthopaedic surgeon. We have identified that a high percentage of patients referred to shoulder surgery sub-specialists for chronic full-thickness rotator cuff tears have not undergone appropriate non-operative treatment prior to being referred, and ultimately do not require surgery. In an effort to improve the referral process and to optimize patient care, we have sought to identify clinical predictors for outcome of non-operative treatment of chronic full-thickness rotator cuff tears. This would allow general practitioners to clearly identify patients who are most likely to fail non-operative treatment and actually require surgical consultation. We now must further this understanding by examining the longer term outcomes (2 years) of patients to ensure that we are not simply delaying inevitable surgical fixation.
Objectives:
-To follow up with participants in a previous study who received non-operative treatment of a chronic full-thickness rotator cuff tear to determine if they maintained their outcome at 6-months, 12-months, and 24-months
Anticipated Results:
Rotator cuff surgery results in significant time loss from work, varying between one to two weeks and up to 6 months or more, depending on the demands of the patient’s job. If a patient can avoid surgery and achieve successful outcomes with a non-operative program, the cost savings to the WCB would be significant. Not only would the costs of the surgery and post-operative rehabilitation be saved, but also the costs of the patient being off work while they recover from surgery. Further, quality of life for the patient would be enhanced as they avoid the stress and discomfort of post-surgical rehabilitation. However, we must be confident that patients maintain their successful outcomes over the longer term before suggesting that avoiding surgery is an appropriate course of treatment.
Investigators:
Richard Boorman (University of Calgary)
