Effects of total shoulder arthroscopy versus small-incision rotator cuff repair for rotator cuff injury

Jun WANG; Shengchun ZHAO; Hongwei CHEN

ABSTRACT

Objective:

To investigate the effects of total shoulder arthroscopy versus small-incision rotator cuff repair on shoulder range of motion, postoperative pain, and complications in patients with rotator cuff injury.

Methods:

The clinical data of 106 patients with rotator cuff injuries treated in Yiwu Central Hospital between June 2018 and July 2021 were retrospectively analyzed. These patients were divided into an observation group and a control group according to different treatment regimens, with 53 patients in each group. The control group underwent arthroscopic small-incision rotator cuff repair. The observation group underwent total shoulder arthroscopy. Perioperative indicators, pain (Visual Analogue Scale score) before surgery and 1, 3, and 6 months after surgery, shoulder range of motion and shoulder-elbow function before surgery, and 3 and 6 months after surgery and postoperative complications were compared between the two groups.

Results:

Operative time in the observation group was significantly longer than that in the control group [(98.67 ± 12.31) minutes vs. (85.72 ± 10.53) minutes, t = 5.82, P < 0.01). Intraoperative blood loss, postoperative passive shoulder expansion time, and hospital stay in the observation group were (28.66 ± 3.12) mL, (5.61 ± 1.03) days, and (14.17 ± 2.26) days, which were significantly shorter than (37.68 ± 3.59) mL, (7.22 ± 1.41) days and (17.21 ± 3.04) days in the control group ( t = 13.81, 6.71, 5.86, all P < 0.01). After surgery, the Visual Analogue Scale score in each group significantly decreased compared with that before surgery (both P < 0.05). At 1, 3, and 6 months after surgery, the Visual Analogue Scale score in the observation group was (2.46 ± 0.63) points, (1.53 ± 0.42) points, and (1.03 ± 0.26) points, respectively, which were significantly lower than (3.04 ± 0.74) points, (1.84 ± 0.51) points, and (1.21 ± 0.34) points in the control group ( t = 4.35, 3.42, 3.06, all P < 0.01). At 3 and 6 months after surgery, the ranges of motion of shoulder abduction, external rotation, and internal rotation in each group significantly increased compared with those before surgery (all P < 0.05). The scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles in each group were significantly increased compared with those before surgery (both P < 0.05). After treatment, there were no significant differences in the scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles between the two groups (both P < 0.05). By 6 months after surgery, the incidence of complications in the control group was 3.77%. No obvious complications were observed in the observation group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.51, P > 0.05).

Conclusion:

Compared with small-incision rotator cuff repair, total arthroscopic rotator cuff repair has less invasive trauma and mild pain and is more conducive to postoperative shoulder function recovery.