Rotator cuff disease: Opinion regarding surgical criteria and likely outcome

Abstract

Background: Clinical guidelines for the management of rotator cuff disease are not clear. Surgeon surveys in the USA and UK lack agreement regarding surgical indications. Physical examination tests aid surgical decision-making but also lack robust evidence. Study aims were to evaluate: Western Australian orthopaedic surgeons' perceptions about surgical indications; utility of physical examination tests; findings at surgery predictive of outcome and surgeon opinion of a successful surgical outcome. Methods: An anonymous rotator cuff survey, previously reported by the American Academy of Orthopaedic Surgeons, was emailed to all surgeons listed with the Australian Orthopaedic Association in Western Australian. Surgeons who treated patients for rotator cuff disease during the previous 12months were invited to complete the rotator cuff survey and five additional questions were included to capture the above criteria of interest. Results: Within a close community of surgeons based in Western Australia (n=23) considerable heterogeneity exists in surgical decision-making criteria. A successful surgical outcome was considered to include reduced pain levels, restoration of movement and function and gains in muscle strength. Conclusions: Research is required to inform robust clinical practice guidelines for rotator cuff surgery. Identification of prognostic factors for successful surgical outcome is imperative.