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Surgical management of rotator cuff tears in adults: Prospective study of 50 consecutive patients and professional practice self-assessment.

Abstract：

INTRODUCTION:As part of quality-improvement efforts, we self-assessed our professional practices regarding the surgical management of rotator cuff tears comparatively to recommendations issued by the French National Authority for Health (HAS). MATERIAL AND METHODS:An independent observer prospectively evaluated 50 consecutive patients with rotator cuff tears treated surgically over a 1-year period. For each patient, we identified divergences with the 20 relevant HAS recommendations. RESULTS:Initially, 54% of practices were found to diverge from HAS recommendations, 10% regarding the preoperative work-up, 14% the duration of initial medical treatment, and 30% the nature of the surgical procedure. DISCUSSION:A review of the data showed that 26% of practices diverged from recommendations, 10% regarding the preoperative work-up, 2% the duration of initial medical treatment, and 14% the nature of the surgical procedure. Overall, for the 26% of divergent practices, 10% were related to judgement or evaluation errors and 16% to a deliberate and substantiated decision made by the surgeons. CONCLUSION:The clinical practice guidelines issued by the HAS, although useful and necessary, were shown by our study to exhibit a number of limitations. Thus, our data illustrate the complexity of surgical management decisions. LEVEL OF EVIDENCE:Level IV (cases series).

journal_name

Orthop Traumatol Surg Res

journal_title

Orthopaedics & traumatology, surgery & research : OTSR

authors

Williot A,Favard L

doi

10.1016/j.otsr.2013.03.005

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

S259-66

issue

4 Suppl

issn

1877-0568

pii

S1877-0568(13)00050-9

journal_volume

99

pub_type

杂志文章

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