Arthroscopic Treatment of Shoulder Stiffness With Rotator Cuff Repair Yields Similar Outcomes to Isolated Rotator Cuff Repair

• DOI: 10.1016/j.asmr.2023.05.008
• Publication Date: 2023-07-25T19:33:03Z
• Authors: Parker L. Brush; Adrian Santana; Ruchir Nanavati; Gregory R. Toci; Tariq Z. Issa; Daniel J. Fletcher; Joshua Hornstein
• Keywords: Shoulder; Surgical Procedures; Arthroscopic Surgery; 610; Sports Medicine; Operative; 3. Good health; Stiffness; Arthroscopy; Rotator Cuff; Treatment Outcome; Orthopedics; Sports medicine; Medicine and Health Sciences; Technical Note; Surgery; Musculoskeletal System; RC1200-1245

Purpose: To compare patient-reported and surgical outcome measures in patients with and without secondary shoulder stiffness (SSS) undergoing rotator cuff repair (RCR). Methods: Patients undergoing rotator cuff repair from 2014 to 2020 with complete patient-reported outcome measures (PROMs) by the short-form 12 survey (SF-12) were retrospectively reviewed to identify if operative intervention for SSS was performed alongside the RCR. Those patients with operative intervention for SSS were propensity matched to a group without prior intervention for stiffness by age, sex, laterality, body mass index, diabetes mellitus status, and the presence of a thyroid disorder. The groups were compared by rotator cuff tear (RCT) size, surgical outcomes, further surgical intervention, rotator cuff retear rate, postoperative range of motion (ROM), and SF-12 results at one year after surgery. Delta values were calculated for component scores of the SF-12 and ROM values by subtracting the preoperative result from the postoperative result. Results: A total of 89 patients with SSS were compared to 156 patients in the control group at final analysis. SSS group experienced a significant improvement by the delta mental health component score (MCS-12) of the SF-12 survey that was not seen in the control group (p=0.005 to p=0.539). Both groups experienced significant improvement by the delta physical health component score (PCS-12) of the SF-12 survey (SSS: 7.68, p&l;0.001; control: 6.95, p&l;0.001). The SSS group also experienced greater improvement of their forward flexion (25.80 vs 12.9°, p-0.005) and external rotation (7.13° vs 1.65°, p=0.031) ROM than the control group. Conclusions: Operative intervention of SSS at the time of RCR has equivalent postoperative outcomes by the SF-12 survey when compared to patients undergoing RCR without preoperative stiffness.