Browsing by Author "Rao, Allison J."

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    Is the impact of previous rotator cuff repair on the outcome of reverse shoulder arthroplasty clinically relevant? A systematic review of 2879 shoulders
    (Sage, 2024-08-10) Berk, Alexander N.; Rao, Allison J.; Obana, Kyle K.; Ifarraguerri, Anna M.; Trofa, David P.; Connor, Patrick M.; Schiffern, Shadley C.; Hamid, Nady; Saltzman, Bryan M.; Orthopaedic Surgery, School of Medicine
    Background: Outcomes of reverse shoulder arthroplasty (RSA) in patients with prior rotator cuff repair (RCR) remain inconsistent. The purpose of this study, therefore, was to systematically review the current outcomes literature on RSA in patients with prior RCR and to compare the results with controls without prior RCR. Methods: A systematic review of the literature was performed, and outcome studies reporting on functional and clinical outcomes were included. Results: A total of 11 studies encompassing 2879 shoulders were included. Improvements in postoperative patient-reported outcomes (PROs) from the baseline were higher in controls including the American Shoulder and Elbow Surgeons score (47.0 vs 39.5), Simple Shoulder Test (6.0 vs 4.9), Constant score (32.6 vs 26.4), and Visual Analog Scale for pain (-5.6 vs -4.9). Improvement in range of motion was greater in the control group, including external rotation (17° vs 11°), anterior elevation (56° vs 43°), and abduction (52° vs 43°). The overall complication rate (8% vs 5%) and revision rate (3% vs 1%) were higher in the RCR group. Discussion: Differences in postoperative PROs and improvement from the baseline demonstrate a trend toward lower outcomes in patients with prior RCR but may be below the minimal clinically import difference.
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    Rates of retear following rotator cuff repair are similar between men and women
    (Elsevier, 2025-01-16) Harley, Jonathan D.; Ray, Lucas J.; Olson, Conner P.; Comfort, Spencer M.; Harrison, Alicia K.; Saltzman, Bryan M.; Rao, Allison J.; Orthopaedic Surgery, School of Medicine
    Hypothesis: A systematic review and meta-analysis was conducted investigating sex-based differences in retear rate after arthroscopic rotator cuff repair (RCR). It is hypothesized that females experience a higher rate of retear than males. Methods: We performed a systematic review of 3 databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were written in English, published in a peer-reviewed journal, included patients with a history of arthroscopic RCR, reported failure rate based on sex, and had level of evidence 3 or higher. To assess failure, we used retear as our primary outcome, defined as a loss of structural integrity of the rotator cuff after primary repair, confirmed by imaging. Complications, reoperation, and patient-reported outcomes (PRO) were secondary outcomes. Results: In 11 eligible studies, there were 3134 patients, 1787 female (57%) and 1476 male (43%). Of 11 studies, 10 reported sex-specific rates of retear, 3 reported complications by sex, 3 reported reoperation by sex, and 2 reported PROs by sex. A random-effects model demonstrated no significant difference in retear rates between females and males (mean difference, .010 [95% CI, -.068 to .087]; P = .81). Limited reporting prevented analysis for complication or reoperation rates. One study found significantly higher American Shoulder and Elbow Surgeons scores (92.2 vs. 88.2, P = .002), Constant-Murley Score scores (92.2 vs. 81.8, P < .001) and significantly lower visual analog scale pain scores (.75 vs. 1.39, P < .001) for males compared with females. No other significant differences in PROs were found. A random-effects model showed a significant difference in age between patients with and without retear (mean difference, 4.38 years [95% CI, 1.81-6.95]; P < .001). Conclusion: Female and male patients showed no significant difference in retear rate following arthroscopic RCR. Retears were associated with increased age, which aligns with previous findings in the existing literature. Since many studies reported only one or a few of the desired outcomes, increasing the uniformity of outcome reporting related to RCR failure may be beneficial.