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On Saturday 11 June 2011, Dr John North, Chairman of the Orthopaedic Assessment Tribunal, delivered a presentation to the Australian Orthopaedic Association Scientific Conference which highlighted some important considerations for insurers and medical practitioners relating to shoulder surgery for workers with a diagnosis of frozen shoulder.
Shoulder surgery for workers' compensation patients - What the figures say!
Introduction - A Medical Assessment Tribunal doctor expressed concern regarding the outcomes noted for people that have surgical intervention for adhesive capsulitis (frozen shoulder). Q-COMP representatives were asked if there was any data available to evaluate the hypothesis that patients who have surgery for frozen shoulder have worse outcomes than those who are treated conservatively.
Methods - The workers' compensation data set was assessed to evaluate if there were differences in the outcomes for frozen shoulder sufferers for those who had been treated surgically versus conservatively.
Results - There was a clear difference in outcomes for the respective groups with those undergoing surgery receiving almost four times the amount of weekly compensation benefits, having three times as much time away from work, two and a half times the amount spent on physiotherapy and for those that proceeded to common law being awarded double the amount of damages.
Discussion - The figures are correlational only but strongly suggest that surgical intervention for compensated patients with frozen shoulder should always be carefully considered by surgeons, insurers and patients.
What's next?
Dr Leigh Atkinson has also asked Q-COMP to perform a similar review of the data to set the outcomes of lumbar fusion surgery for compensated patients. The results of this will be circulated to all once available.
It must be stressed that the outcomes of these investigations provide correlational information only that is intended to better inform the Medical Community, Insurers and Workers. It is not intended to in any way be substituted for proper clinical evaluation of surgical procedures.