Arthroscopic Rotator Cuff Repair and Subsequent Career Changes in Manual Workers: A Long-term Observational Study.

Background: Although arthroscopic rotator cuff repair (ARCR) is widely performed for rotator cuff tears, the extent to which manual laborers can return to their original occupations remains unclear. This study aimed to evaluate the proportion of manual workers who change or discontinue their professional activity following ARCR. Methods: A retrospective review was conducted of patients who underwent ARCR by a single surgeon between December 2010 and June 2014. Inclusion criteria were a minimum follow-up of 9 years and employment in a manual labor occupation before surgery. Patients completed a long-term follow-up assessment, which included a professional activity questionnaire (primary outcome) and shoulder function evaluations (secondary outcome). Results: A total of 165 patients (55 women, 110 men; mean age 53 ± 5 years at the time of surgery) were followed for an average of 11 ± 1 years. Of these, 128 patients (77%) resumed the same occupation postoperatively, while 37 patients (23%) changed or discontinued their work. There was no group difference for the subjective shoulder value at the final follow-up between physical workers and repetitive workers (p = 0.75). A significant association was found between occupational change and poorer shoulder function, as reflected by lower Constant scores (p = 0.008). The median time to occupational change was 12 months (interquartile range: 6-60 months). The mean was 29.7 ± 33.8 months. Change in professional activity was not associated with the presence of a full-thickness retear (p = 0.70), initial tear type (p = 0.23), or sex (p = 0.09). However, salaried employees were more likely to change their occupation than self-employed individuals (p = 0.02). Conclusions: Most manual workers can maintain their original occupation following ARCR. However, approximately 1 in 4 patients changes or abandons their job, potentially due to suboptimal shoulder function. Self-employed individuals appear less likely to modify their professional activity. Clinical Relevance: Manual laborers undergoing ARCR can generally expect to resume their professional duties. Nevertheless, persistent shoulder symptoms may necessitate a career transition in some cases. Level of Evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.