What is the optimal surgical intervention for patients with frozen shoulder and a concomitant partial-thickness rotator cuff tear?

Lim, Winston Eng Hoe; Lie, Denny; Mitra, Amit; Chang, Paul Chee Cheng

doi:10.1016/j.jseint.2020.06.010

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…It has been established that individuals with frozen shoulders without rotator cuff tears had a better prognosis following arthroscopic capsular release than those with partial tears. [31] In the present study, 14 patients had preoperative frozen shoulder with terrible pain, all of whom had been in the condition for more than 6 months, and who had been inadequately treated with conservative treatment and were strongly motivated to undergo surgery. We released the capsular membrane at the same time, but also effectively repaired the partially torn rotator cuff, not only to improve the symptoms, to help the shoulder joint with early functional exercise, to avoid the recurrence of frozen shoulder, but also to stop the progression of the partial tear, so that the long-term effect of the treatment is guaranteed.…”

Section: Discussionmentioning

confidence: 81%

Clinical investigation on the efficacy of modified Mason-Allen in healing delaminated rotator cuff tears

Wu,

Hu,

Guan

et al. 2023

Preprint

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Purpose To evaluate the arthroscopic modified Mason-Allen (mMA) suture technique's clinical effectiveness and safety in treating delaminated rotator cuff injuries. Methods Collected 62 patients with delaminated rotator cuff tears repaired using arthroscopic modified Mason-Allen suture technique from May 2022 to June 2023, including 21 males and 41 females; age ranged from 50 to 81 years old, with a median age of 65 years old; 34 cases in the left shoulder and 28 cases in the right shoulder; 30 cases with a history of trauma and 32 cases with no obvious history of trauma; According to the Cofield classification of rotator cuff tears, all were delaminated tears of the rotator cuff (1 to 3 cm). We recorded changes in shoulder joint range of motion (ROM) and functional ratings from 3 to 6 months following surgery, with a median of 6 months. Follow-up visits were undertaken to assess tendon-bone healing, improvement of shoulder discomfort, recovery of shoulder joint function, and incidence of problems. Results All patients were followed up for 3 to 6 months, with a median of 6 months. The MRI demonstrated excellent tendon-bone healing in all patients at the last follow-up. Shoulder anterior flexion supination improved from 98.06°±11.28°to 169.05° ± 9.05°, abduction supination improved from 69.68°±18.55°to 147.86°± 11.16°, internal rotation improved from 14.52°±10.35°to 47.62°± 6.91°, and external rotation improved from 22.42°±8.62°to 49.76°±6.04°; Constant-Murely score, preoperative (49.08 ± 4.91) and at the last follow-up (93.33 ± 4.95); and UCLA shoulder score, preoperative (15.73 ± 2.60) and at the last follow-up (33.55 ± 1.53). The change was statistically significant when comparing the data before and after surgery (P < 0.001). Eight patients acquired frozen shoulder symptoms after surgery owing to inconsistent rehabilitation activities, and the symptoms resolved after standardized rehabilitation exercises. All patients did not experience issues such as rotator cuff re-tear and anchor nail removal. Conclusion Repair with arthroscopic modified Mason-Allen suture technique can restore the wholeness and integrity of the delaminated rotator cuff, which can effectively alleviate shoulder joint pain, help early exercise, prevent and control further rotator cuff tear, enhance the initial strength of the rotator cuff as a whole, and improve the joint function of patients. Level of evidence III.

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Section: Discussionmentioning

confidence: 81%

Clinical investigation on the efficacy of modified Mason-Allen in healing delaminated rotator cuff tears

Wu,

Hu,

Guan

et al. 2023

Preprint

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“…They are usually handicapped mainly by pain and stiffness, both of which are amenable to physiotherapy. Outcomes with and without repair of such partial tears with stiffness are noted to be similar [38].…”

Section: Patients Who May Not Need Surgerymentioning

confidence: 87%

Role And Outcomes of Conservative Treatment in Management of Rotator Cuff Tears: A Systematic Review of Randomised Controlled Trials

Sayampanathan¹,

Tan²,

Lie³

2021

AJA

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Rotator cuff tears are known to result in significant societal burden. This review synthesises the evidence regarding the role and outcomes of conservatively managed rotator cuff tears. 17 prospective randomised controlled trials (RCTs) (Level 1 and 2 studies) were included in this systematic review. Modalities which were studied were classified into physical rehabilitative modalities, electrophysiological rehabilitative modalities, biological therapies, and pharmacologic therapies. Outcomes which were evaluated in the included RCTs comprised of clinical outcomes, functional outcomes, pain scores, quality of life scores, imaging based outcomes, and patient satisfaction scores. As the modalities and outcomes studied were varied, no quantitative analysis could be performed based on the primary data available. Nevertheless, most studies do suggest that conservative treatment remains beneficial for the management of rotator cuff tears. Based on these findings, an algorithm which proposes conservative therapy as the central mode of management for rotator cuff tear patients has been described. More high-quality studies are required in this area of study to allow for a quantitative review (meta-analysis and meta-regression) of the various non-surgical treatment modalities of rotator cuff tears. Keywords: Rotator Cuff Tears; Conservative; Non-operative; Management; Randomised controlled trials; Review.

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Analysis of risk factors and construction of nomogram model for arthroscopic single-row rivet repair

Fan,

Ouyang,

Chen

et al. 2024

BMC Musculoskelet Disord

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Background The factors influencing the clinical outcome of arthroscopic rotator cuff repair are not fully understood. Purpose To explore the factors related to the postoperative outcome of arthroscopic single-row rivet rotator cuff repair in patients with rotator cuff injury and to construct the related nomogram risk prediction model. Methods 207 patients with rotator cuff injury who underwent arthroscopic single-row rivet rotator cuff repair were reviewed. The differences of preoperative and postoperative Visual Analogue Score (VAS) scores and University of California, Los Angeles (UCLA) scores were analyzed and compared. The postoperative UCLA score of 29 points was taken as the critical point, and the patients were divided into good recovery group and poor recovery group, and binary logstic regression analysis was performed. According to the results of multivariate logistic regression analysis, the correlation nomogram model was constructed, and the calibration chart was used, AUC, C-index. The accuracy, discrimination and clinical value of the prediction model were evaluated by decision curve analysis. Finally, internal validation is performed using self-random sampling. Results The mean follow-up time was 29.92 ± 17.20 months. There were significant differences in VAS score and UCLA score between preoperative and final follow-up ( p < 0.05); multivariate regression analysis showed: Combined frozen shoulder (OR = 3.890, 95% CI: 1.544 ∼ 9.800), massive rotator cuff tear (OR = 3.809, 95%CI: 1.218 ∼ 11.908), More rivets number (OR = 2.118, 95%CI: 1.386 ∼ 3.237), lower preoperative UCLA score (OR = 0.831, 95%CI: 0.704–0.981) were adverse factors for the postoperative effect of arthroscopic rotator cuff repair. Use these factors to build a nomogram. The nomogram showed good discriminant and predictive power, with AUC of 0.849 and C-index of 0.900 (95% CI: 0.845 ∼ 0.955), and the corrected C index was as high as 0.836 in internal validation. Decision curve analysis also showed that the nomogram could be used clinically when intervention was performed at a threshold of 2%∼91%. Conclusion Combined frozen shoulders, massive rotator cuff tears, and increased number of rivets during surgery were all factors associated with poor outcome after arthroscopic rotator cuff repair, while higher preoperative UCLA scores were factors associated with good outcome after arthroscopic rotator cuff repair. This study provides clinicians with a new and relatively accurate nomogram model.

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What is the optimal surgical intervention for patients with frozen shoulder and a concomitant partial-thickness rotator cuff tear?

Cited by 3 publications

References 36 publications

Clinical investigation on the efficacy of modified Mason-Allen in healing delaminated rotator cuff tears

Clinical investigation on the efficacy of modified Mason-Allen in healing delaminated rotator cuff tears

Role And Outcomes of Conservative Treatment in Management of Rotator Cuff Tears: A Systematic Review of Randomised Controlled Trials

Analysis of risk factors and construction of nomogram model for arthroscopic single-row rivet repair

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