Surgical management of rotator cuff tears in adults: Prospective study of 50 consecutive patients and professional practice self-assessment - 18/05/13
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Summary |
Introduction |
As part of quality-improvement efforts, we self-assessed our professional practices regarding the surgical management of rotator cuff tears comparatively to recommendations issued by the French National Authority for Health (HAS).
Material and methods |
An independent observer prospectively evaluated 50 consecutive patients with rotator cuff tears treated surgically over a 1-year period. For each patient, we identified divergences with the 20 relevant HAS recommendations.
Results |
Initially, 54% of practices were found to diverge from HAS recommendations, 10% regarding the preoperative work-up, 14% the duration of initial medical treatment, and 30% the nature of the surgical procedure.
Discussion |
A review of the data showed that 26% of practices diverged from recommendations, 10% regarding the preoperative work-up, 2% the duration of initial medical treatment, and 14% the nature of the surgical procedure. Overall, for the 26% of divergent practices, 10% were related to judgement or evaluation errors and 16% to a deliberate and substantiated decision made by the surgeons.
Conclusion |
The clinical practice guidelines issued by the HAS, although useful and necessary, were shown by our study to exhibit a number of limitations. Thus, our data illustrate the complexity of surgical management decisions.
Level of evidence |
Level IV (cases series).
El texto completo de este artículo está disponible en PDF.Keywords : Rotator cuff tears, National clinical practice guidelines, Self-assessment of professional practices
Esquema
Vol 99 - N° 4S
P. S259-S266 - juin 2013 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.