Impact of work-related compensation claims on surgical outcome of patients with rotator cuff related pathologies: a matched case-control study.
BACKGROUND
The purpose of this matched case-control study was to examine the impact of an active compensation claim following a work-related shoulder injury on reporting disability, as measured by subjective and objective outcomes at 1 year postoperatively.


METHODS
Data of 517 consecutive patients who had undergone a decompression or rotator cuff repair were reviewed. One-hundred and ten patients were on compensation related to their shoulder problems. These patients were matched with a historical control group (patients without a compensation claim) based on age, sex, and level of pathology. Outcome measures used were the Western Ontario Rotator Cuff Index, the American Shoulder and Elbow Score, and the Constant-Murley score. Nonparametric Wilcoxon and Ranked sign tests were conducted to examine the difference between and within groups.


RESULTS
Data of 220 patients were used for analysis (mean age, 48+/-10; range, 20-69). Out of 110 patients in each group, 45 patients (41%) had undergone a repair and 65 (59%) had undergone a decompression surgery (acromioplasty with or without resection of lateral clavicle). Both groups improved significantly regardless of their claim status (P < .0001). There was a significant difference between injured and noninjured workers at baseline, 1-year postoperatively, and in overall improvement with the compensation group having a significantly higher level of disability.


CONCLUSIONS
Our results show that although injured workers report a statistically significant higher level of disability before and after rotator cuff surgery, they still show significant improvement 1 year following decompression or repair of the rotator cuff tendon(s).
Holtby
Richard
R
Division of Orthopedic Surgery, Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Razmjou
Helen
H
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D016896:Treatment Outcome; D014937:Work; D014942:Workers' Compensation; D055815:Young Adult