Rotator Cuff Repair: Racial Disparities in Operative Time and Utilization of Arthroscopic Techniques

TL;DR

This study finds no racial differences in post-surgery complications for rotator cuff repair but notes Black patients had longer surgeries and more arthroscopic procedures.

Contribution

The study reveals racial disparities in surgical technique and operative time for rotator cuff repair, despite similar complication rates.

Findings

Black patients had longer operative times (≥80 minutes) compared to White patients.

Black patients were more likely to undergo arthroscopic rather than open rotator cuff repair.

No significant differences in 30-day postoperative complications were found between Black and White patients.

Abstract

Background

Racial disparities are prevalent within the field of orthopedics and include the utilization of varying resources as well as outcomes following surgery. This study investigates racial differences between Black and White patients in the surgical treatment of rotator cuff repair (RCR) and 30-day postoperative complications following RCR.

Materials and methods

Data were drawn from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to create a study population consisting of Black and White patients who underwent RCR between 2015 and 2019. A bivariate analysis was conducted to compare patient demographics and comorbidities. Multivariate logistic regression, controlling for all significantly linked patient demographics and comorbidities, was performed to examine the relationships between Black race and complications.

Results

Our analysis included 32,073 patients, of whom 3,318 (10.3%) were Black and 28,755 (89.7%) were White. The female gender, younger age groups, greater BMI groups, ASA classification ≥3, cigarette use, and comorbid congestive heart failure (CHF), diabetes, and hypertension were all significantly associated with patients who identified as Black. We found no significant differences in 30-day postoperative complications between Black and White patients. Furthermore, Black patients were found to be independently associated with a greater likelihood of undergoing arthroscopic RCR versus open RCR, as well as experiencing a longer total operation time of ≥80 minutes.

Conclusions

We report no differences in 30-day postoperative complications between Black and White patients undergoing RCR between 2015 and 2019. However, Black race was independently associated with higher rates of arthroscopic RCR and longer operative times.

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