Postoperative Outcomes of Patients Undergoing Rotator Cuff Repair With Osteoporosis: A TriNetX Database Study

Speaker(s)

Johnson A1, Brennan J2, Rana P1, Petre B1, Morganti C1, Turcotte J1, Redziniak D1
1Luminis Health, Annapolis, MD, USA, 2Luminis Health, Stevensville, MD, USA

Presentation Documents

OBJECTIVES: Bone quality is an important factor in the success of rotator cuff repair (RCR) although the effects preexisting osteoporosis have not been well studied in this population. The purpose of this study is to compare 1- and 3-year outcomes of patients undergoing arthroscopic rotator cuff repair (ARCR) with and without a preoperative diagnosis of osteoporosis.

METHODS: The TriNetX database was queried for all patients undergoing ARCR and divided into two cohorts by whether they had a history of osteoporosis. Cohorts were 1:1 propensity score matched; 3,427 patients remained in each cohort after matching. The following outcomes were evaluated at 1 and 3 years postoperatively: repeat ARCR, surgical site infection, adhesive capsulitis, open RCR, repeat open or arthroscopic RCR, proximal humerus fracture, and shoulder arthroplasty.

RESULTS: Following propensity score matching the only differences remaining between groups were BMI and rates of congestive heart failure. Patients undergoing ARCR with osteoporosis were 1.60 (OR: 0.625, 95% CI: 0.514 to 90.761; p<0.001) and 1.43 (OR: 0.700, 95% CI: 0.593 to 0.827; p<0.001) times less likely to undergo repeat ARCR and were 1.55 (OR: 0.644, 95% CI: 0.532 to 0.779; p<0.001) and 1.36 (OR: 0.734, 95% CI: 0.624 to 0.864; p<0.001) times less likely to undergo repeat open or arthroscopic RCR at 1 and 3 years respectively. ARCR patients with osteoporosis were 1.79 (OR: 1.073 to 2.993; p=0.024) and 1.67 (OR: 1.131 to 2.470; p=0.009) times more likely to have a proximal humerus fracture at 1 and 3 years postoperatively.

CONCLUSIONS: Patients undergoing ARCR with osteoporosis were less likely to undergo repeat open or arthroscopic RCR at 1 and 3 years postoperatively but were more likely to experience postoperative proximal humerus fracture. The overall complication rate was low. Patients should be counseled regarding increased risks, but osteoporosis should not be a deterrent to ARCR.

Code

RWD133

Topic

Clinical Outcomes, Real World Data & Information Systems

Topic Subcategory

Clinical Outcomes Assessment, Distributed Data & Research Networks

Disease

Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Surgery