One-stage arthroscopic repair of rotator cuff tears with shoulder stiffness

Abstract

Purpose: The purpose of this study is to describe a 1-stage treatment with concomitant arthroscopic capsular release and rotator cuff repair and present clinical outcomes with a minimum follow-up of 2 years.

Methods: Arthroscopic rotator cuff repair was performed in 211 consecutive patients. Forty-three patients had severe concomitant shoulder stiffness at the time of the repair. In the stiffness group, 1-stage arthroscopic capsular release and rotator cuff repair were performed. Preoperative mean passive forward flexion was 124°, whereas external rotation at the side was 309°. All patients were evaluated at a minimum 2-year follow-up, which included a visual analog scale score for pain, tests of muscle power and range of motion, the Constant score, and the modified American Shoulder and Elbow Surgeons shoulder evaluation form and modified University of California, Los Angeles scores.

Results: The mean visual analog scale score during motion at the last follow-up was 1.5 in the stiffness group and 1.3 in the non-stiffness group. In the stiffness group, forward flexion was 175° whereas external rotation at the side was 60° postoperatively; shoulder motion improved (P < .001) and was comparable with that of the contralateral side. Other functional outcome instruments showed no statistical difference between the 2 groups.

Conclusions: In this study, 1-stage treatment of patients with rotator cuff tears and shoulder stiffness was performed by arthroscopic capsular release and cuff repair, and overall satisfactory results were achieved in selected patients. The results of the stiffness group in this study were statistically the same as those in the non-stiffness group.

Level of evidence: Level III, retrospective comparative study.