Outcomes of closed manipulation and arthroscopic repair for rotator cuff tears combined with shoulder stiffness

다국어 초록 (Multilingual Abstract)

Background: Some patients with rotator cuff tears have preoperative shoulder stiffness, and this may affect the functional outcomes after repair of the rotator cuffs. The purpose of this study was to evaluate the outcomes of closed manipulation and arthroscopic repair of rotator cuff tears in patients with combined preoperative shoulder stiffness.
Methods: Of the 200 patients who underwent arthroscopic rotator cuff repair from January 2008 to December 2012, 18 patients had preoperative shoulder stiffness at the time of repair. The incidence of preoperative shoulder stiffness was 9.0% (18 of 200 patients). All patients underwent closed manipulation and arthroscopic rotator cuff repair concomitantly, and had a sling with an abduction pillow for 6 weeks except when changing clothes. All patients were evaluated preoperatively and at a minimum of 1-year follow-up using the visual analog scale (VAS) for pain, Constant score, and ultrasonograpy.
Results: The mean preoperative VAS and Constant scores were 7.6 and 50.6, respectively. The mean VAS score at the last follow-up was 2.8, and the mean Constant score was 82.4. The functional outcomes improved compared with the preoperative state (P < 0.001). Results were in 9 cases “excellent”, in 5 cases “good”, in 2 cases “fair”, and in 2 cases “poor”. Of the 5 patients who showed severe shoulder stiffness preoperatively, 2 later showed poor functional outcomes. Repair integrities noted postoperatively were 12 intact cuffs, 5 partial-thickness tears, and 1 full-thickness tear, as determined by the Naqvi classification.
Conclusion: We suggest that concomitant closed manipulation and arthroscopic rotator cuff repair could be a simple and an effective surgical treatment for rotator cuff tears combined with shoulder stiffness.