Factors Affecting Cost, Outcomes, and Tendon Healing After Arthroscopic Rotator Cuff Repair

Background The purpose of this study was to simultaneously examine costs, functional outcomes, and tendon healing after arthroscopic rotator cuff repair. Methods This was a retrospective, single-surgeon, single-hospital study. Pre- and postoperative Simple Shoulder Test (SST), visual analog scale (VAS) pain, and American Shoulder and Elbow Surgeons (ASES) scores, and postoperative magnetic resonance images (MRIs) were obtained. Direct costs were derived using a unique, validated tool. Costs included overall total direct cost, which included facility use costs, medication costs, supply costs, and other ancillary costs. Results 85 patients had a minimum 1-year follow-up of functional outcomes (mean of 1.24 years, range 1-3.2 years) and 56 of 85 (66%) had postoperative MRI healing data at an average follow-up of 1.3 years (range 1-3.2 years). Increased direct cost was associated with ASA class III ( P P  = .017) compared with those at the surgical center, single-row repair ( P P P  = .001) compared with small tear, and increased number of anchors ( P ≤ .001 or P P P  = .03). Obesity ( P  = .004) and smoking ( P  = .034) were associated with greater improvement in VAS-pain scores as these were associated with decreased preoperative scores. Seventy percent of tears healed. Conclusions Within our study, factors that increased direct costs were outcome neutral, and factors that improved outcome were cost neutral. Level of Evidence Level IV, retrospective.