Tuesday, August 9, 2016

Arthroscopic rotator cuff repair - types of complications

Complications associated with arthroscopic rotator cuff tear repair: definition of a core event set by Delphi consensus process

These authors conducted a Delphi consensus process with an international panel of experienced shoulder surgeons to develop an organized list of complications of arthroscopic rotator cuff repair (ARCR) occurring within two years after surgery.

The events were categorized as follow: 

  fixation device - malposition, displacement

  osteochondral - arthritis, cuff tear arthropathy, osteonecrosis, chondrolysis, acromioclavicular arthritis, fracture, loose body, bone cyst, osteolysis, chondromalacia

  persistent or worsening pain

  rotator cuff - recurrent or new tear

  peripheral nerve problem - nerve injury, complex regional pain syndrome

  vascular - hematoma, thrombosis

  infection - superficial, deep

  skin - wound healing issues, keloid

  deep soft tissue - subacromial adhesions, biceps, stiffness, deltoid

Comment: Our understanding of the complications of shoulder surgery has been compromised by the lack of a standardized system for identifying and recording these events. This is a well thought out list relating to arthroscopic cuff repair. General application of this schema will show us the most important and most common complications, the factors associated with them and how they can best be avoided and treated.

It would be most useful to have a similarly developed list of the complications following other shoulder procedures, such as arthroplasty, instability repairs, and fracture surgery.