Clinical Outcomes of Rotator Cuff Repair With Arthroscopic Capsular Release and Manipulation for Rotator Cuff Tear With Stiffness: A Matched-Pair Comparative Study Between Patients With and Without Stiffness

• Published in: Arthroscopy Vol. 31; no. 3; pp. 482 - 487
• Main Authors: Cho, Chul-Hyun, M.D., Ph.D, Jang, Hyung-Kyu, M.D, Bae, Ki-Cheor, M.D, Lee, Si Wook, M.D, Lee, Young-Kuk, M.D, Shin, Hong-Kwan, M.D, Hwang, Ilseon, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2015
• Subjects: Adult; Aged; Arthroscopy; Female; Humans; Joint Capsule Release; Male; Manipulation, Orthopedic; Matched-Pair Analysis; Middle Aged; Orthopedics; Prognosis; Range of Motion, Articular; Retrospective Studies; Rotator Cuff - physiopathology; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Tendon Injuries - complications; Tendon Injuries - physiopathology; Tendon Injuries - surgery; Treatment Outcome
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2014.09.002

Purpose To compare clinical outcomes after surgical treatment between rotator cuff tears with and without shoulder stiffness and evaluate the serial changes in pain intensity, functional scores, and range of motion (ROM). Methods The study comprised 26 patients with preoperative stiffness (stiff group) and 26 patients without stiffness (non-stiff group). The stiff group underwent arthroscopic or mini-open rotator cuff repair with arthroscopic capsular release and manipulation. The non-stiff group with rotator cuff repair only was matched for age and sex with the stiff group. The visual analog scale (VAS) pain score; University of California, Los Angeles (UCLA) score; American Shoulder and Elbow Surgeons (ASES) score; and ROM were evaluated preoperatively; 3, 6, and 12 months after surgery; and at final follow-up. Results Both groups had significant improvements in the VAS pain score, UCLA score, ASES score, and ROM at final follow-up. There were no significant differences between the 2 groups regarding VAS pain score, UCLA score, and ASES score at any period after surgery. In the stiff group, mean forward flexion was significantly lower than that in the non-stiff group at 3 months after surgery (143.1° v 154.2°, P  = .003). Mean external rotation and internal rotation were significantly lower than those in the non-stiff group at 3 months after surgery (37.9° v 44.2°, P  = .043, and 15.8 v 13.9, P < .001, respectively) and 6 months after surgery (49.1° v 57.3°, P  = .002, and 13.2 v 12.0, P  = .033, respectively). Conclusions Overall satisfactory clinical outcomes could be achieved in both the stiff and non-stiff groups, although the stiff group had slower postoperative recovery of ROM until 6 months after surgery. Level of Evidence Level III, retrospective comparative study, prognosis study.