Analysis of one-stage surgical treatment of rotator cuff tear combined with shoulder stiffness / 中华骨科杂志

ABSTRACT

Objective:To compare the outcomes of arthroscopic rotator cuff repair in patients with or without stiffness.Methods:Retrospective analysis was performed on the data of 20 patients (stiffness group) who underwent arthroscopic rotator cuff repair combined with capsular release from January 2017 to November 2019. There are 9 males and 11 females, age 62.2±8.7 years old (range 45 to 80 years old), preoperative duration 5.2±4.3 months (range 1 to 12 months). 54 patients who underwent arthroscopic rotator cuff repair without stiffness were used as the control group. There were 16 males and 38 females, aged 60.9±9.1 years old (range 46 to 81 years old), preoperative duration 8.2±13.0 months (range 1 to 60 months). Pain, function and range of motion (ROM) were recorded at 1 month, 3 months, 6 months post-operatively and last follow-up, and compared with that of pre-operatively. Satisfaction and complication were recorded at the last follow-up. The main outcome measurements included the visual analogue scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles shoulder rating scale (UCLA), Constant-Murley score, and range of motion.Results:The mean follow-up period was 19.7±4.6 months (12-30 months) in the stiffness group, and 18.6±4.4 months (12-29 months) in non-stiffness group. VAS, ASES score, UCLA score, Constant-Murley score and ROM were significantly improved post-operatively. One month post-operatively, the VAS score was 4.2±1.5 in stiffness group, and 3.4±1.1 in the non-stiff group, and the difference was statistically significant between two groups ( t=2.381, P=0.020). There was no significant difference at 3 months post-operatively. The ASES score, UCLA score and Constant-Murley score were 52.3±10.2, 17.8±4.2 and 51.7±9.7 in stiffness group at 3 months post-operatively, and 57.4±7.4, 21.6±3.8, 63.2±13.5 in non-stiffness group, respectively. The difference was statistically significant ( t=2.363, P=0.021; t=3.713, P<0.001; t=3.484, P<0.001). There was no significant difference at 6 months post-operatively. The postoperative satisfaction of stiffness group and the non-stiffness group were 95.0% and 96.3%, respectively. The difference was not statistically significant ( χ2=0.2511, P=0.802). Conclusion:The results of stiffness group are statistically the same as those in non-stiffness group at last follow-up, although the recovery period is longer in patients who combined with stiffness at the first 6 months.