Postoperative Compliance and Return to Work After Rotator Cuff Repair: Value of an Interactive Online Rehabilitation Program Among Patients Treated Under Workers' Compensation.

Outcomes after rotator cuff repair (RCR) typically are poorer for workers' compensation (WC) than for patients with private insurance. This study examined augmentation of the traditional rehabilitation protocol with an online exercise program. Between March 2016 and July 2018, 48 WC patients who underwent RCR were introduced to a digital rehabilitation program (application). Patients were divided into patients who used the application along with traditional physical therapy (PT) (group 1) and patients who underwent only traditional PT (group 2). Patient performance was assessed using standardized patient-reported outcome measures (PROMs), return-to-work (RTW) status, number of PT sessions, and complication/revision rate. Patients were monitored for a minimum of 1 year postoperatively. A significant improvement in RTW period was noted for group 1 patients, who resumed modified duty 10 weeks earlier than group 2 patients. A positive trend also was noted for return to full duty, with group 1 resuming full duty 7 weeks before group 2. There were no complications or reoperations in group 1 compared with 4 (16%) complications in group 2. The 2 groups underwent the same average number of PT sessions (27 sessions). Patient-reported outcome measures were captured only for group 1, which demonstrated average postoperative improvement of 3 points on a visual analog scale and 32.5 points in American Shoulder and Elbow Surgeons scores. Incorporating an online exercise program within the traditional rehabilitation protocol for WC patients undergoing RCR resulted in earlier return to work and was associated with better pain relief, greater return of function, and lower complication rate. [Orthopedics. 2021;44(2):e197-e202.].

Meniscal repair using the Polysorb Meniscal Stapler XLS.

We present our technique of repair of meniscal tears in 11 patients using a newly designed stapler, the Polysorb Meniscal Stapler XLS (USS Sports Medicine, Norwalk, CT), to increase the effectiveness and ease of repair of tears in the vascular zone while limiting potential complications. The low-profile stapler comes with a reloadable pistol grip device and a disposable straight or 15 degrees upcurved shaft with a single preloaded 10-mm staple. Standard anteromedial and anterolateral portals were used, along with a superomedial portal for inflow. The portal was enlarged slightly to facilitate introduction of the cannula or the stapler directly into the knee. The nose of the stapler was applied to the superior surface of the inner edge of the meniscal tear. The sharp points on the tip of the nose were used to manipulate the inner edge and coapt the tear site. Firm pressure was applied to the meniscal tissue, and the nose of the stapler was embedded in the inner edge of the meniscus no more than 2 to 3 mm from the tear (as measured along the meniscal surface). The handle was pulled slowly as the staple engaged the meniscal tissue. This step was repeated every 3 to 4 mm to ensure ideal tear stabilization.