Types and doses of anti‐adhesive agents injected into subacromial space do not have an effect on the clinical and anatomical outcomes after arthroscopic rotator cuff repair

Abstract

Purpose Joint stifness after arthroscopic rotator cuf repair is a major concern for orthopaedic surgeons. Various antiadhesive agents are commonly administered after rotator cuf repair for its prevention. This study aimed to compare the outcomes among patients injected with diferent types and amounts of anti-adhesive agents after rotator cuf repair. It was hypothesized that the outcomes might difer depending on the use of the anti-adhesive agent and its type and dose. Methods A total of 267 patients who underwent arthroscopic rotator cuf repair with or without subacromial injection of anti-adhesive agents were enrolled. The irst group (group A; 51 patients) were injected with 3 mL of poloxamer/sodium alginate-based anti-adhesive agent. The second group (group B; 93 patients) were injected with 3 mL of sodium hyaluronatebased anti-adhesive agent. The third group (group C; 82 patients) were injected with 1.5 mL of sodium hyaluronate-based anti-adhesive agent. Finally, the last group (group D; 41 patients) who did not use anti-adhesive agents served as the control. The range of motion (ROM) and pain VAS scores were measured preoperatively and at 5 weeks, 3 months, 6 months, and 1 year postoperatively. Functional outcomes were evaluated using American Shoulder and Elbow Surgeons and Constant scores, whereas cuf integrity was assessed via MRI or ultrasonography at least 6 months postoperatively. Results All ROM measurements, pain VAS scores, and functional scores were signiicantly improved regardless of the use, type, and dose of the anti-adhesive agents. In addition shoulder ROM and rotator cuf healing did not signiicantly difer among the groups (all n.s.). Conclusions No signiicant diferences were found in the clinical and anatomical outcomes according to the type and dose of the anti-adhesive agents subacromially injected after rotator cuf repair. Level of evidence III.