Factors Associated with Shoulder Range of Motion After Arthroscopic Rotator Cuff Repair: A Hospital‐Based Prospective Study

Abstract

Objective: To assess the factors associated with outcomes of arthroscopic surgical repair of rotator cuff tears (RCTs).Method: This prospective study recruited patients, at least 18 years old, who underwent arthroscopic rotator cuff repair for full-thickness RCTs at the First People's Hospital of Hangzhou Xiaoshan between July 2019 and October 2020. Patient demographics, lifestyle habits, and medical histories were collected preoperatively; RCT sizes and affected tendons were determined intraoperatively. Outcomes were assessed by shoulder range of motion (ROM) determinations 1.5 and 3 months postoperatively. The factors associated with ROM were determined using a binary logistic regression analysis, and the results were expressed as adjusted relative risks (RRs) and 95% confidence intervals (CIs).Results: A total of 132 patients with RCTs underwent arthroscopic surgery. Five were lost to follow-up, leaving 127 patients (mean age, 59 years; 58.3% women) who were included in the study analysis. The majority of the patients (54.5%) had RCTs that were classified as large or massive, and approximately 20% had tears involving multiple tendons; 80.3% of the patients had tears involving only a single tendon. Moreover, 29.9% of the patients had hypertension and 11.0% had diabetes. Among the patients, 23.0% were smokers and 34.6% drank alcohol. According to the multivariate analysis, none of the assessed factors were associated with shoulder ROM at the 1.5-month follow-up. At the 3-month follow-up, RCTs involving a single tendon demonstrated 3-fold better abduction (RR = 4.00; 95% CI, 1.30-12.33; P = 0.016) and 3.15-fold better internal rotation (RR = 3.15; 95% CI, 1.19-8.36; P = 0.021) than did RCTs involving multiple tendons. Patients who did not drink alcohol demonstrated 6.08-fold better anteflexion (RR = 7.08; 95% CI, 2.11-23.73; P = 0.002) and nearly 4-fold better abduction (RR = 4.97; 95% CI, 1.62-15.23; P = 0.005) than patients who drank alcohol. Conclusion:To improve outcomes, the results indicate that more targeted measures should be directed toward patients with multiple-tendon RCTs and that preoperative alcohol abstinence education is needed for patients with RCTs.