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. 2018 Jan 15;32(1):1-6.
doi: 10.7507/1002-1892.201708073.

[Effectiveness of rotator cuff repair with manipulation release and arthroscopic debridement for rotator cuff tear with shoulder stiffness]

[Article in Chinese]
Xin Tang  1 , Fuguo Huang  1 , Gang Chen  1 , Qi Li  1 , Weili Fu  1 , Jian Li  2
Affiliations

[Effectiveness of rotator cuff repair with manipulation release and arthroscopic debridement for rotator cuff tear with shoulder stiffness]

[Article in Chinese]
Xin Tang et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To investigate effectiveness of rotator cuff repair with manipulation release and arthroscopic debridement for rotator cuff tear with shoulder stiffness.

Methods: A retrospectively study was performed on the data of 15 patients with rotator cuff tear combined with shoulder stiffness (stiff group) and 24 patients without stiffness (non-stiff group) between January 2014 and December 2015. The patients in the stiff group underwent arthroscopic rotator cuff repair with manipulation release and arthroscopic debridement while the patients in the non-stiff group only received arthroscopic rotator cuff repair. The patients in the stiff group were older than the patients in the non-stiff group, showing significant difference ( P<0.05). There was no significant difference in gender, type of rotator cuff tear, side of rotator cuff tear, and combined with diabetes between 2 groups ( P>0.05). The visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were used to evaluate the effectiveness after operation.

Results: All incisions healed by first intention without any complication after operation. The patients were followed up 13-31 months in the stiff group (mean, 19.2 months) and 13-23 months in the non-stiff group (mean, 20.3 months). There was no significant difference in follow- up time between 2 groups ( t=-0.573, P=0.570). The VAS score in the stiff group was higher than that in the non-stiff group before operation ( t=-2.166, P=0.037); there was no significant difference between 2 groups at 3, 6, 12 months and last follow-up ( P>0.05). The forward flexion and external rotation were significantly lower in the stiff group than those in the non-stiff group before operation and at 3 months after operation ( P<0.05); there was no significant difference between 2 groups at 6, 12 months and last follow-up ( P>0.05). At last follow-up, the internal rotation was beyond L 3 level in 2 groups. The preoperative UCLA score was significant lower in the stiff group than that in the non-stiff group ( P=0.037); but there was no significant difference in UCLA score at last follow-up between 2 groups ( P=0.786). There was no significant difference in pre- and post-operative ASES scores between 2 groups ( P>0.05).

Conclusion: Satisfactory effectiveness can be achieved in the patients with rotator cuff tear combined with shoulder stiffness after rotator cuff repair with manipulation release and arthroscopic debridement, although the patients with shoulder stiffness had slower postoperative recovery of ROM until 6 months after operation.

目的: 探讨一期手法松解联合关节镜下清理肩袖修补术治疗肩袖撕裂合并冻结肩的疗效。.

方法: 回顾分析 2014 年 1 月—2015 年 12 月采用一期手法松解联合关节镜下清理肩袖修补术治疗的 15 例肩袖撕裂合并冻结肩患者（冻结肩组）临床资料，并与同期关节镜下肩袖修补术治疗的 24 例肩袖撕裂不合并冻结肩患者（非冻结肩组）进行比较。冻结肩组患者年龄大于非冻结肩组（ P<0.05）；两组患者性别、肩袖撕裂分型、损伤侧别、合并糖尿病例数比较，差异均无统计学意义（ P>0.05）。术后肩关节疼痛程度采用疼痛视觉模拟评分（VAS），关节功能采用美国加州大学肩关节功能评分系统（UCLA）以及美国肩肘协会评分系统（ASES）评价。.

结果: 两组术后切口均Ⅰ期愈合，无手术早期相关并发症发生。两组患者均获随访，其中冻结肩组随访时间为 13～31 个月，平均 19.2 个月；非冻结肩组为 12～33 个月，平均 20.3 个月；两组随访时间比较，差异无统计学意义（ t=–0.573， P=0.570）。冻结肩组术前 VAS 评分高于非冻结肩组（ t=–2.166， P=0.037）；术后 3、6、12 个月及末次随访时，两组间比较差异无统计学意义（ P>0.05）。冻结肩组术前及术后 3 个月肩关节活动范围（肩外旋及前屈）低于非冻结肩组（ P<0.05），术后 6、12 个月及末次随访时组间比较差异无统计学意义（ P>0.05）。末次随访时两组患者内旋均超过 L 3。两组术后 UCLA、ASES 评分均较术前明显改善（ P<0.05）。其中冻结肩组术前 UCLA 评分低于非冻结肩组（ P=0.037），但末次随访时两组比较差异无统计学意义（ P=0.786）。两组手术前后 ASES 评分比较差异均无统计学意义（ P>0.05）。.

结论: 一期手法松解联合关节镜下清理肩袖修补术治疗肩袖撕裂合并冻结肩，早期疗效略差于肩袖撕裂不合并冻结肩，但 6 个月后可获得相似疗效。.

Keywords: Rotator cuff tear; arthroscopy; manipulation release; rotator cuff repair; shoulder stiffness.

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Figures

图 1
图 1
The arthroscopic appearance for rotator cuff tear combined with stiff shoulder 冻结肩组关节镜下操作所见
图 2
图 2
Comparison of VAS score of the shoulder at different time points between 2 groups 两组手术前后 VAS 评分比较
图 3
图 3
Comparison of anterior flexion of the shoulder at diffe rent time points between 2 groups 两组手术前后肩前屈活动度比较
图 4
图 4
Comparison of external rotation of the shoulder at diffe rent time points between 2 groups 两组手术前后肩外旋活动度比较
图 5
图 5
A 55-year-old female patient with right rotator cuff tear combined with stiff shoulder 冻结肩组患者，女，55 岁，右侧肩袖撕裂合并冻结肩
See this image and copyright information in PMC

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