LAUSR

Abstract Aims This study aimed to establish a real-world benchmark of recovery following rotator cuff repair (RCR) using healthcare claims data. Secondary objectives included determining the effect of comorbidities and complications such as joint contracture, additional procedures, and rehospitalizations on the recovery timeline and costs. Materials and Methods Healthcare claims data from the IBM MarketScan Commercial Claims and Encounters Database (2015–2018) were reviewed to determine costs and recovery time after RCR. Costs and recovery duration (index surgery to last therapy claim) were calculated. Subgroup analyses assessed the effects of comorbidities (diabetes, obesity, peripheral vascular disease, cardiovascular disease) and postoperative events (revision, motion restoring surgery (MRS), complication-related surgery, and nonoperative hospitalization) on outcomes. Perioperative complications including joint fibrosis/contracture, infection, and pulmonary embolus were also reported. Descriptive statistics including medians with interquartile ranges (IQR) were reported. Results In the 14,947 patients included in analysis, median index surgery cost was $11,454 (IQR = $8,169–$17,204). Median recovery was 153 days (IQR = 79–683). Development of postoperative shoulder contracture or adhesive capsulitis added a median of 162 recovery days and nearly doubled costs. Patients requiring surgery for a complication had 3.5-fold longer recoveries and 5-fold higher costs than those without complications. MRS increased recovery time and costs nearly 3-fold, and patients undergoing MRS were 7 times more likely to require arthroplasty. Comorbidities extended recovery by 30–90 days, modestly increased costs, and were associated with a 2–3 times higher frequency of pulmonary embolism. Limitations Claims data may be affected by coding inconsistencies, lack of clinical detail, and inability to capture medication costs or outcomes beyond the last therapy claim. Conclusions This study defined a benchmark for recovery after RCR and found that complications including contracture and motion restoring surgery substantially increased recovery time and costs. These benchmarks can guide earlier identification of patients at risk for delayed recovery and help in evaluating strategies to reduce economic burden and improve outcomes. PLAIN LANGUAGE SUMMARY Rotator cuff repair (RCR) is one of the most common shoulder surgeries performed in the United States. Recovery after this procedure varies widely, and some patients experience complications that extend rehabilitation and increase costs. This study analyzed healthcare claims data from the IBM MarketScan database (2015–2018) to establish context for recovery and identify factors linked with delays and higher costs. We reviewed records from 14,947 patients who underwent RCR. The median cost of the initial surgery was $11,454 and the typical recovery period was about 5 months (153 days) across all 14,947 patients. A RCR with no complications had a median postoperative cost of $2,708 and recovery time of 139 days. Complications significantly increased both recovery time and costs. Patients who developed shoulder stiffness (contracture or adhesive capsulitis) had recoveries that were twice as long and nearly twice as expensive. We found that 8.7% of patients required additional surgery. Those who underwent motion-restoring procedures, such as manipulation under anesthesia, had recoveries nearly three times longer and costs almost three times higher. Revision surgeries and hospitalizations for infection or blood clots were linked with even greater delays and expenses with a median postoperative cost of $41,880 and recovery time of 459 days in revision patients. Common health conditions such as diabetes, obesity and cardiovascular disease also extended recovery by 1–3 months and raised the risk of complications. These findings provide new, real-world context for recovery after rotator cuff repair. Understanding how complications and comorbidities affect outcomes can help clinicians identify at-risk patients earlier, guide treatment decisions, and inform strategies to reduce delays, improve recovery, and manage healthcare costs.