Serious Risk of Reoperation After Rotator Cuff Repair if the Neck is Arthritic

One more way to get stung — missing referred pain from the neck when you propose cuff repair

Serious Risk of Reoperation After Rotator Cuff Repair if the Neck is Arthritic

What’s the Claim?

A complicated large-database study carries a simple message: Patients undergoing rotator cuff repair who also have cervical spondylosis (DJD) are at much higher odds of having reoperation on the same shoulder for other causes within 2 years (adjusted odds ratio = 1.61 [95% CI 1.55 -1.66]). These reoperations included but were not limited to debridement (aOR = 1.66 [1.57-1.75]), distal clavicle excision (aOR = 1.78 [1.66-1.91]), subacromial decompression (aOR = 1.72 [1.63-1.81]), biceps tenodesis (aOR = 1.76 [1.63-1.90]), conversion to shoulder arthroplasty (aOR = 1.62 [1.49-1.75]), and revision rotator cuff repair (aOR = 1.77 [1.68-1.85]). And that’s just a partial list.

What does this mean? It means that some of these patients were misdiagnosed with a shoulder problem, likely underwent the wrong operation the first time around, and quite possibly, the second time, too. Many of them probably did have a surgical shoulder problem, but perhaps a larger (or equally large) cervical spine problem.

How’s It Stack Up?