Effect of abduction brace wearing angle on clinical outcomes after arthroscopic repair of large repairable rotator cuff: a retrospective study

Abstract

Background: Rotator cuff tears affect approximately 20% of the population and are usually repaired arthroscopically. The clinical outcomes of these repairs are influenced by multiple factors, including patient characteristics, surgical technique, and postoperative management. Postoperative shoulder posture, particularly the degree of abduction, plays an important role in repair site tension and tendon-bone healing. This study aimed to evaluate the clinical outcomes and repair integrity of patients undergoing arthroscopic repair of large rotator cuff tears using a 30° and 45° abduction brace.

Methods: A total of 82 patients with symptomatic full-thickness rotator cuff tears were included in this study. The control group included 40 patients using a 30° brace, and the study group included 42 patients using a 45° abduction brace. Visual analogue scales (VAS) and humerohumeral range of motion were obtained before surgery and at 1 month (M1), 3 months (M3), and 6 months (M6) after surgery. Shoulder function scores (including Constant-Murley (CMS), University of California, Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores) and retear rates were assessed at final follow-up (24 months).

Results: Early passive ROM (flexion at 1 month, abduction at 1 and 3 months, external rotation at 1 and 3 months) was significantly better in the study group (45° abduction brace, P < 0.05). At 24 months, there were no significant differences in shoulder range of motion, function scores, and retear rates between the two groups (P > 0.05). Of note, in subgroup analysis, the retear rate was lower with a 45° brace than with a 30° brace under moderate to severe repair tension (16.67% vs. 44.44%, P < 0.05).

Conclusions: These results suggest that immobilization with a 45° brace rather than a 30° abduction brace after arthroscopic repair of large rotator cuff tears results in better passive range of motion during early follow-up, particularly with lower retear rates at moderate to severe repair strains.

Keywords: 45/30 degrees; Arthroscopy; Brace; Rotator cuff; Shoulder.

Fig. 1

Study flowchart. Flowchart describing the patient selection process of the study

Fig. 2

The pain scores of the 2 groups during follow-up. No significant differences were found. (VAS = visual analog scale, M1 = 1 month after surgery, M3 = 3 months after surgery, M6 = 6 months after surgery)

Fig. 3

The glenohumeral forward flexion of the 2 groups. Patients with 45° abduction brace was significant greater at M1. (GH = glenohumeral)

Fig. 4

The glenohumeral abduction of the 2 groups. Patients with 45° abduction brace was significant greater at M1 and M3. (GH = glenohumeral)

Fig. 5

The glenohumeral external rotation (arm at side) of the 2 groups. Patients with 45° abduction brace was significant greater at M1 and M3. (GH = glenohumeral)