Christopher R Millican1, Patrick H Lam1, George A C Murrell2. 1. Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, NSW, Australia. 2. Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, NSW, Australia. Electronic address: murrell.g@ori.org.au.
Abstract
BACKGROUND: Stiffness and retear are 2 common complications of rotator cuff repair. McNamara et al found that postoperative stiffness was associated with lower retear rates at 6 months. This study aimed to determine if stiffness after rotator cuff repair protects the individual from retear up to 9 years after surgery. MATERIALS AND METHODS: Two groups of patients, 69 with stiff and 63 with nonstiff shoulder, who underwent arthroscopic rotator cuff repair were created based on external rotation measurements at 6 weeks postoperatively. Patients had regular follow-up assessments at 6, 12, and 24 weeks and were instructed to return for a follow-up at least 2 years after surgery. Patients were assessed for range of motion, shoulder function, strength, and rotator cuff integrity using ultrasound. RESULTS: For patients with postoperative stiffness at 6 weeks, the retear rate at 6 months was 3%, whereas the rate for nonstiff patients was 19% (P = .004). This protective effect of postoperative stiffness persisted up to 9 years after surgery (P = .002). Postoperative stiffness resolved by 5 years after surgery for all measurements except external rotation (50° vs. 61°) (P = .006). Patients with postoperative stiffness had continued improvements in abduction (P < .001), internal rotation (P = .020), and all patient-ranked measurements from the 6-month follow-up to 5 years after surgery. Patients with stiff shoulder had greater overall satisfaction by the final follow-up (P = .028). CONCLUSIONS: In patients experiencing stiffness after rotator cuff surgery, the repair is less likely to fail at 6 months. Although the stiffness generally resolves by 5 years, this protective effect still persists at 9 years after surgery.
BACKGROUND: Stiffness and retear are 2 common complications of rotator cuff repair. McNamara et al found that postoperative stiffness was associated with lower retear rates at 6 months. This study aimed to determine if stiffness after rotator cuff repair protects the individual from retear up to 9 years after surgery. MATERIALS AND METHODS: Two groups of patients, 69 with stiff and 63 with nonstiff shoulder, who underwent arthroscopic rotator cuff repair were created based on external rotation measurements at 6 weeks postoperatively. Patients had regular follow-up assessments at 6, 12, and 24 weeks and were instructed to return for a follow-up at least 2 years after surgery. Patients were assessed for range of motion, shoulder function, strength, and rotator cuff integrity using ultrasound. RESULTS: For patients with postoperative stiffness at 6 weeks, the retear rate at 6 months was 3%, whereas the rate for nonstiff patients was 19% (P = .004). This protective effect of postoperative stiffness persisted up to 9 years after surgery (P = .002). Postoperative stiffness resolved by 5 years after surgery for all measurements except external rotation (50° vs. 61°) (P = .006). Patients with postoperative stiffness had continued improvements in abduction (P < .001), internal rotation (P = .020), and all patient-ranked measurements from the 6-month follow-up to 5 years after surgery. Patients with stiff shoulder had greater overall satisfaction by the final follow-up (P = .028). CONCLUSIONS: In patients experiencing stiffness after rotator cuff surgery, the repair is less likely to fail at 6 months. Although the stiffness generally resolves by 5 years, this protective effect still persists at 9 years after surgery.
Authors: Ryan H Barnes; Anthony V Paterno; Feng-Chang Lin; Jingru Zhang; David Berkoff; R Alexander Creighton Journal: Orthop J Sports Med Date: 2022-06-14