Clinical Outcomes of Rotator Cuff Repair With Arthroscopic Capsular Release and Manipulation for Rotator Cuff Tear With Stiffness: A Matched-Pair Comparative Study Between Patients With and Without Stiffness

Cho, Chul-Hyun; Jang, Hyung-Kyu; Bae, Ki-Cheor; Lee, Si Wook; Lee, Young-Kuk; Shin, Hong-Kwan; Hwang, Ilseon

doi:10.1016/j.arthro.2014.09.002

Cited by 33 publications

(38 citation statements)

References 20 publications

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“…In fact, a recent literature review by Papalia et al [41] shows that excessive postoperative stiffness after rotator cuff repair can occur in up to 33% of cases. In turn, patients with shoulder stiffness require a longer period of time to achieve postoperative return of function, and patients with severe preoperative stiffness have a higher rate of poor outcomes after rotator cuff repair [42, 43]. …”

Section: Discussionmentioning

confidence: 99%

Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study

et al. 2017

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IntroductionWhat is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery?MethodsRetrospective 10-year review of a shoulder surgeon’s practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire.ResultsApproximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection. Over 95% of patients stated that the injections helped reduce shoulder pain and increased function 6 weeks post-injection. Twenty-two percent of cases (208/945) received glenohumeral and/or subacromial injections. The 208 injected cases had these diagnoses: rotator cuff tear (28% of injected patients), subacromial impingement (20%), glenohumeral instability (16%), subacromial impingement with acromioclavicular osteoarthritis (10%), adhesive capsulitis (7%), SLAP lesion (5%), biceps tendinopathy (3%), glenohumeral instability with subacromial impingement (3%), proximal humerus fracture (2%), calcific tendinitis (2%), and less common conditions (4%). Diagnoses among those with the highest rates of injected patients per diagnosis included: SLAP lesions (40%), calcific tendinitis (40%), adhesive capsulitis (29%), subacromial impingement (28%), proximal humerus fracture (24%), rotator cuff tear (19%), and glenohumeral instability (16%). Significant differences (p < 0.03) were found between patients who did and did not receive injections with respect to age (more likely younger patients with cuff tear) and sex (more likely female with subacromial impingement and instability) but not for diabetes or arthroscopic vs. open procedures.ConclusionThis is the first study to establish the rates of postoperative shoulder corticosteroid injections within the first 6 months after various non-arthroplasty shoulder surgeries for patients with high pain/stiffness. These data will be useful for establishing guidelines for using corticosteroid injections along with physiotherapy.

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Section: Discussionmentioning

confidence: 99%

Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study

et al. 2017

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“…Fortunately, we have good literature and professional experience indicating that everything is going to be just fine. [1][2][3] The current study adds to the confidence we can have simultaneously treating these 2 disparate diagnoses with vastly different rehabilitation goals.…”

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confidence: 93%

Editorial Commentary: Don't Let Cuff Tears With Adhesive Capsulitis Give You the Cold Shoulder

Knapp¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Despite vastly different rehabilitation goals, adhesive capsulitis and a rotator cuff tear of the shoulder can be treated concomitantly with good outcomes. In the face of adhesive capsulitis, rotator cuff tears can be safely repaired with manipulation under anesthesia and/or capsular release without a substantial increase in complication rates compared with patients undergoing rotator cuff repair alone. Adhesive capsulitis pathology causes the cuff to heal rapidly, and we recommend aggressive passive range of motion as part of a traditional but accelerated rehabilitation that can be monitored and thus adjusted on a case-by-case basis.

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“…Several studies [ 8 – 10 ] reported preoperative prognostic factors associated with functional outcome after ARCR. Pécora et al [ 10 ] showed that age is an independent predictive factor for obtaining good and excellent results after ARCR.…”

Section: Introductionmentioning

confidence: 99%

“…Pécora et al [ 10 ] showed that age is an independent predictive factor for obtaining good and excellent results after ARCR. Cho et al [ 8 ] reported that the presence or absence of preoperative contractures affects internal and external rotation up to 6 months postoperatively, and contractures are also cited as prognostic factors. Ohzono et al [ 9 ] reported that preoperative fatty degeneration of the subscapularis muscle and infraspinatus muscle affects clinical outcomes following the repair of large/extensive rotator cuff tears without re-tear.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors affecting clinical outcomes after arthroscopic rotator cuff repair: importance of functional recovery by 3 months after surgery

et al. 2018

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BackgroundTo examine important factors that affect clinical outcomes following arthroscopic rotator cuff repair (ARCR).MethodsAmong 163 patients who underwent ARCR, we included 71 shoulders in 71 patients whose progress was monitored for > 2 years, postoperatively. We divided the patients into groups A (scores ≥ 83 points, 59 patients) and B (scores < 83 points, 12 patients) using the Japanese Orthopedic Association (JOA) score at 24 months. We then conducted univariate and multivariate analyses of pre- and postoperative (2 and 3 months, respectively) factors.ResultsThe mean JOA score for all patients significantly improved from 63.7 ± 11.5 points preoperatively to 90.3 ± 9.6 points at 24 months postoperatively (P < 0.05). However, there were no significant between-group differences in the preoperative scores. In addition, there were no significant differences in the postoperative re-tear rate. Univariate analysis revealed that the range of motion (preoperative abduction and postoperative elevation, abduction, internal rotation, and external rotation), muscle strength (external rotation 3 months postoperatively), postoperative pain level [visual analog scale (VAS) maximum score, 10 points], partial repair, Cofield classification, and preoperative width were significant factors (P < 0.05 for all factors). Multivariate and receiver operating characteristic curve analyses showed that VAS at 2 months postoperatively and elevation at 3 months postoperatively were significant factors.ConclusionsTo obtain a JOA score of ≥ 83 points at 24 months postoperatively, following ARCR, a postoperative VAS of < 5 points at 2 months and postoperative elevation of ≥ 110° at 3 months should be achieved.

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Clinical Outcomes of Rotator Cuff Repair With Arthroscopic Capsular Release and Manipulation for Rotator Cuff Tear With Stiffness: A Matched-Pair Comparative Study Between Patients With and Without Stiffness

Cited by 33 publications

References 20 publications

Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study

Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study

Editorial Commentary: Don't Let Cuff Tears With Adhesive Capsulitis Give You the Cold Shoulder

Prognostic factors affecting clinical outcomes after arthroscopic rotator cuff repair: importance of functional recovery by 3 months after surgery

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