1.Golf participation after rotator cuff repair: functional outcomes, rate of return and factors associated with return to play
Thomas R WILLIAMSON ; Patrick G ROBINSON ; Iain R MURRAY ; Andrew D MURRAY ; Julie M MCBIRNIE ; C Michael ROBINSON ; Deborah J MACDONALD ; Nicholas D CLEMENT
Clinics in Shoulder and Elbow 2023;26(2):109-116
Golf is a popular sport involving overhead activity and engagement of the rotator cuff (RC). This study aimed to determine to what level golfers were able to return to golf following RC repair, the barriers to them returning to golf and factors associated with their failure to return to golf. Methods: Patients preoperatively identifying as golfers undergoing RC repair at the study centre from 2012 to 2020 were retrospectively followed up with to assess their golf-playing status, performance and frequency of play and functional and quality of life (QoL) outcomes. Results: Forty-seven golfers (40 men [85.1%] and 7 women [14.9%]) with a mean age of 56.8 years met the inclusion criteria, and 80.1% were followed up with at a mean of 27.1 months postoperatively. Twenty-nine patients (76.3%) had returned to golf with a mean handicap change of +1.0 (P=0.291). Golf frequency decreased from a mean of 1.8 rounds per week preinjury to 1.5 rounds per week postoperatively (P=0.052). The EuroQol 5-dimension 5-level (EQ-5D-5L) index and visual analog scale (EQ-VAS) score were significantly greater in those returning to golf (P=0.024 and P=0.002), although functional outcome measures were not significantly different. The primary barriers to return were ipsilateral shoulder dysfunction (78%) and loss of the habit of play (22%). Conclusions: Golfers were likely (76%) to return to golf following RC repair, including mostly to their premorbid performance level with little residual symptomatology. Return to golf was associated with a greater QoL. Persistent subjective shoulder dysfunction (78%) was the most common barrier to returning to golf. Level of evidence: Level IV.
2.Accuracy and clinical outcomes of coronary CT angiography for patients with suspected coronary artery disease: a single-centre study in Singapore.
Awesh Shamrao GAMBRE ; Charlene LIEW ; Gayan HETTIARACHCHI ; Sheldon Shao Guang LEE ; Michael MACDONALD ; Carmen Jia Wen KAM ; Angeline Choo Choo POH
Singapore medical journal 2018;59(8):413-418
INTRODUCTIONThis study aimed to assess the accuracy and outcomes of coronary computed tomography angiography (CCTA) performed in a regional hospital in Singapore.
METHODSThe Changi General Hospital CCTA database was retrospectively analysed over a 24-month period. Electronic hospital records, catheter coronary angiography (CCA) and CCTA electronic databases were used to gather data on major adverse cardiovascular events (MACE) and CCA results. CCTA findings were deemed positive if coronary artery stenosis ≥ 50% was reported or if the stenosis was classified as moderate or severe. CCA findings were considered positive if coronary artery stenosis ≥ 50% was reported.
RESULTSThe database query returned 679 patients who had undergone CCTA for the evaluation of suspected coronary artery disease. Of the 101 patients in the per-patient accuracy analysis group, there were six true negatives, one false negative, 81 true positives and 13 false positives, resulting in a negative predictive value of 85.7% and positive predictive value of 86.2%. The mean age of the study sample was 53 ± 13 years and 255 (37.6%) patients were female. Mean duration of patient follow-up was 360 days. Of the 513 negative CCTA patients, none developed MACE during the follow-up period, and of the 164 positive CCTA patients, 19 (11.6%) developed MACE (p < 0.001).
CONCLUSIONAnalysis of CCTA studies suggested accuracy and outcomes that were consistent with published clinical data. There was a one-year MACE-free warranty period following negative CCTA findings.