Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleStiffness and Rotator Cuff Tears: Incidence, Arthroscopic Findings, and Treatment Results
Section snippets
Methods
This study was a retrospective evaluation of 74 consecutive patients with arthroscopically confirmed full-thickness tears of the rotator cuff who underwent arthroscopic rotator cuff repair. Two patients were lost to follow-up, leaving 72 patients who were followed up for 2 years. Because we specifically wanted to determine loss of passive ROM (PROM) of the glenohumeral joint only, the scapular was stabilized in each patient with a single examining hand while PROM was measured. This approach
Results
No cases of deltoid morbidity, infection, or vascular or neurologic injury were identified in this study group.
The CTI in group 1 was 3.7, in group 2, 7.7, and in group 3, 12.3 (Fig 4). ANOVA indicated that CTI was significant (P < .0001, with a power of 100). Fisher’s PLSD indicated that CTI was highly significantly different among all groups (P < .001). The average preoperative modified UCLA score was 24.7 for group 1, 21.6 for group 2, and 16.8 for group 3. The average postoperative modified
Discussion
Loss of ROM can occur after rotator cuff repair is performed.8 It was reassuring to note that patients who underwent arthroscopic rotator cuff repair in this study did not experience loss of motion as a result of the surgery. Grouping patients on the basis of degree of stiffness makes sense for study purposes. Our rationale for the exact cutoff for each group is admittedly subjective. Our preliminary studies seemed to indicate that patients with TROMD of 20° or less essentially did not have a
Conclusions
Patients with TROMD of 70° or less will be helped by an arthroscopic rotator cuff repair and routine postoperative rehabilitation. Patients with TROMD greater than 70° have a significant chance of experiencing concomitant adhesive capsulitis and should be treated nonoperatively, at least until they are out of the acute phase of capsulitis. We cannot conclude from our data the exact cause of capsulitis in these patients, but an association has been noted with the usual causes that have been
Acknowledgment
The author thanks Russell Parsons, Ph.D., for statistical advice and assistance with analysis.
References (15)
- et al.
Arthroscopic management of refractory shoulder stiffness
Arthroscopy
(1997) Arthroscopic repair of large rotator cuff tears using the interval slide technique
Arthroscopy
(2004)Arthroscopic rotator cuff repairAnalysis of technique and results of 2 and 3 year follow-up
Arthroscopy
(1998)- et al.
Rotator cuff repair in patients with type 1 diabetes mellitus
J Shoulder Elbow Surg
(2003) - et al.
The diabetic frozen shoulderArthroscopic release
Arthroscopy
(1997) - et al.
Shoulder manipulation in patients with adhesive capsulitis and diabetes mellitusA clinical note
J Shoulder Elbow Surg
(1993) ShouldersFrozen and stiff
Instr Course Lect
(1993)