Rotator cuff injuries

Rotator Cuff Tears: Workers’ Compensation-Compliance and Outcomes

Reports of less than optimal outcome for Rotator Cuff Repair in patients receiving Worker’s Compensation been published in the orthopaedic literature for greater than 20 years. 1  This is
not meant to diminish the role of rotator cuff repairs in this population since substantial benefit still ensues regardless of disparity in return to previous activity2.

More recently, researchers have attempted to identify prognostic factors that may explain these disparities .Bhatia et al identified alcohol use as “ the only prognostic factor to show a
significant association with return to restricted-duty employment and repair failure.” 3  Cuff et. al identified “noncompliance “ as a significant factor stating, “Those Workers’ Compensation patients who had no evidence of noncompliance had significant improvements and more favorable outcomes than the noncompliant Workers’ Compensation patients.” Beletsky et. al suggested that preoperative assessment of functional status might improve outcomes.4

In my experience , a careful pre-operative assessment of worker’s functional status and return to work expectations as well as timely repair and a defined pre-approved post-operative recovery program offers the best opportunity for optimal outcomes.

1Misamore, G W; Ziegler, D W; Rushton, J L 2nd Repair of the rotator cuff. A comparison of results in two populations of patients., The Journal of Bone & Joint Surgery: Sep 1995 – Volume 77 – Issue 9 – p 1335-1339

2K. A. R. Kemp, et. al. Rotator cuff tears in workers’ compensation patients, Occupational Medicine, Volume 61, Issue 8, December 2011, Pages 556-562

3Bhatia, S. et. al Workers’ Compensation Patients After Arthroscopic Full-Thickness Rotator Cuff Repair , Arthroscopy :the Journal of Arthroscopic and Related Surgery . Volume 26, Issue 8, August 2010, Pages 1027-1034

4Beletsky , The Impact of Workers’ Compensation on Patient-Reported Outcomes Measurement Information System Upper Extremity and Legacy Outcome Measures in Patients
Undergoing Arthroscopic Rotator Cuff Repair , Arthroscopy :the Journal of Arthroscopic and Related Surgery: Volume 35, Issue 10, October 2019,Pages 2817-2824

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