Compensation Status as a Risk Factor for Rotator Cuff Repair
It is an option for physicians to advise patients that the following factor correlates with less favorable outcomes after rotator cuff surgery: Worker’s Compensation Status

Rationale
Several authors94, 95, 96 have evaluated the effect of Workers’ compensation on surgical treatment for rotator cuff disease including acromioplasty for tendonitis and repair of full-thickness tears. Based upon one Level II study96and two Level III studies,97, 98 the work group has determined that it is an option for physicians to advise their patients that workers’ compensation status correlates with less favorable outcomes after rotator cuff repair.

One study96 prospectively evaluated 107 shoulders (23 of which were receiving workers’ compensation) at an average of 45 months postoperative from an open rotator cuff repair with the UCLA score. Both groups were comparable with regards to patient age, sex, tear size, preoperative strength and active motion. At final follow-up, patients receiving workers’ compensation had significantly worse UCLA scores compared to those not receiving workers’ compensation. Another study94 prospectively evaluated 106 patients (40 of which were receiving workers’ compensation) at an average of 32 months after arthroscopic acromioplasty for rotator cuff tendonitis with the ASES score, the Simple Shoulder Test and a VAS pain scale. The authors report no statistically significant differences between groups with regards to each of these outcomes although the AAOS work group re-calculated the statistics and found workers’ compensation patients had significantly worse SST and VAS pain scores than those not receiving a claim. The last study95 prospectively evaluated 24 patients (12 receiving workers’ compensation) at an average of 3 years postoperative from an open acromioplasty for rotator cuff tendonitis with UCLA scores. At final evaluation, workers’ compensation patients had significantly worse improvements in pain compared to those not receiving Workers’ compensation.

Based upon the above data, shoulder function as evaluated by the UCLA score, the Simple Shoulder Test and VAS pain scores were all inferior in workers’ compensation patients treated surgically for acromioplasty for rotator cuff tendonitis or rotator repairs compared to a non-workers’ compensation group. This data supports the option of advising patients that workers’ compensation status correlates with less favorable outcomes after rotator cuff surgery.