Functional Outcome of Arthroscopic Repair With Concomitant Manipulation in Rotator Cuff Tears With Stiff Shoulder

Background: Little has been reported on treatment of rotator cuff tears with shoulder stiffness. Hypothesis: Rotator cuff tears with shoulder stiffness will show worse clinical results than will tears without stiffness. Those with stiffness are expected to take longer time in pain reduction and reco...

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Bibliographic Details
Published in:The American journal of sports medicine 2008-07, Vol.36 (7), p.1323-1329
Main Authors: Cho, Nam Su, Rhee, Yong Girl
Format: Article
Language:English
Subjects:
Arthralgia - prevention & control
Arthroscopy
Biological and medical sciences
Care and treatment
Case-Control Studies
Clinical outcomes
Diagnosis
Diseases of the osteoarticular system
Endoscopic surgery
Endoscopy
Humans
Injuries
Investigative techniques, diagnostic techniques (general aspects)
Joint Diseases - physiopathology
Joint Diseases - surgery
Joints
Juxtaarticular diseases. Extraarticular rhumatism
Knee
Medical examination
Medical sciences
Methods
Orthopedic Procedures - methods
Physiological aspects
Range of Motion, Articular
Risk factors
Rotator cuff
Rotator cuff (Anatomy)
Rotator Cuff - physiology
Rotator Cuff - surgery
Rotator Cuff Injuries
Rotator cuff repair
Shoulder
Shoulder injuries
Shoulder Joint - surgery
Sports injuries
Sports medicine
Tensile Strength
Treatment Outcome
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Summary:Background: Little has been reported on treatment of rotator cuff tears with shoulder stiffness. Hypothesis: Rotator cuff tears with shoulder stiffness will show worse clinical results than will tears without stiffness. Those with stiffness are expected to take longer time in pain reduction and recovery of range of motion. Study Design: Case control study; Level of evidence, 3. Methods: Among patients who underwent arthroscopic rotator cuff repairs, 15 cases with preoperative shoulder stiffness (group A) and 30 without shoulder stiffness (group B) were enrolled in this study. Preoperative mean forward flexion was 118.3° in group A and 163.4° in group B, whereas external rotation at the side was 34.6° and 55.0°, respectively. The mean follow-up period of group A was 29.8 months (range, 19.5–73.9 months) and 32.4 months (range, 16–70.6 months) in group B. Results: The mean visual analog scale during motion at the last follow-up was 0.75 in group A and 0.76 in group B ( P = .942). The mean University of California at Los Angeles score was, respectively, 33.1 and 33.2 points ( P = .561). Forward flexion was 166.7° in group A and 170.2° in group B, whereas external rotation at the side was 48.8° and 53.4°, respectively ( P = .157 and .384, respectively). However, the 2 groups showed a significant difference in forward flexion until 1 year postoperatively as group A recovered more slowly ( P = .021). Both groups showed significant differences in external rotation at the side, internal rotation to the back, and cross-body adduction until 6 weeks postoperatively ( P = .009, P < .001, and P = .026, respectively). Conclusion: Pain, range of motion, muscle strength, and function all significantly improved after arthroscopic rotator cuff repair, regardless of the presence of shoulder stiffness. Patients with full-thickness rotator cuff tears and stiffness of the shoulder can be treated with a single surgery and concomitant manipulation with overall good results. Although final outcomes were as good as those in patients without stiffness, the return of range of motion took longer in those patients undergoing manipulation for stiffness of the shoulder. Keywords: shoulder rotator cuff tear arthroscopic repair, stiffness
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546508314402