Inferior outcomes and higher complication rates after shoulder arthroplasty in workers’ compensation patients
These authors compared the complication rates and clinical outcomes after shoulder arthroplasty (total shoulder arthroplasty, reverse total shoulder arthroplasty, or hemiarthroplasty) in workers' compensation patients and control non-WC patients.
These authors compared the complication rates and clinical outcomes after shoulder arthroplasty (total shoulder arthroplasty, reverse total shoulder arthroplasty, or hemiarthroplasty) in workers' compensation patients and control non-WC patients.
They matched 45 WC and 45 non-WC patients by age and sex, with the WC group having a higher rate of prior surgery (82% vs 38%, P < .001).
The WC group had inferior 2-year outcomes for all PROs and forward elevation (P ≤ .001 for all), as well as a higher reoperation rate (16% vs 2%, P = .030) and higher rate of persistent pain at final follow-up (33% vs 11%, P = .021).
On multivariate regression controlling for other variables including number of prior surgical procedures, WC status remained associated with lower improvements in the Simple Shoulder Test (P < .001) scores, as well as a higher reoperation rate (P = .015) and higher rate of persistent pain (P = .027).
Comment: Many reasons have been proposed for the well-documented poorer outcomes in WC patients, including young age, patient sex, higher exceptions, lower motivation, secondary gain, and associated co-morbidities, such as smoking.
Comment: Many reasons have been proposed for the well-documented poorer outcomes in WC patients, including young age, patient sex, higher exceptions, lower motivation, secondary gain, and associated co-morbidities, such as smoking.
This study controls for some of these variables and finds that prior surgery is more frequent in WC patients.
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