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The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients

OBJECTIVES: Background: There is debate as to whether to operate or defer surgery on patients with concomitant rotator cuff tear and shoulder stiffness. The purpose of this study was, therefore, to compare the outcomes in those patients who had both their rotator cuff tear and shoulder stiffness tre...

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Autores principales: McGrath, Jordan, Lam, Patrick Hong, Tan, Martin, Murrell, George A.C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901565/
http://dx.doi.org/10.1177/2325967115S00003
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author McGrath, Jordan
Lam, Patrick Hong
Tan, Martin
Murrell, George A.C.
author_facet McGrath, Jordan
Lam, Patrick Hong
Tan, Martin
Murrell, George A.C.
author_sort McGrath, Jordan
collection PubMed
description OBJECTIVES: Background: There is debate as to whether to operate or defer surgery on patients with concomitant rotator cuff tear and shoulder stiffness. The purpose of this study was, therefore, to compare the outcomes in those patients who had both their rotator cuff tear and shoulder stiffness treated with patients who had a rotator cuff repair but no stiffness. METHODS: Methods: 1232 primary arthroscopic rotator cuff repairs were performed during the study period, including 44 patients who received a concomitant glenohumeral joint capsule release for ipsilateral shoulder stiffness, forming the stiffness group. A chronologically matched group of four rotator cuff repair-only patients before and after each stiffness patient were chosen from the consecutive list of rotator cuff repairs. Twenty-five patients from the stiffness group and 170 patients from the non-stiffness group met the inclusion criteria, leaving a total cohort of 195 patients. Patients completed modified L’Insalata Questionnaires for patient-ranked pain and function scores pre-operatively, intra-operatively, and at one week, six weeks, 12 weeks, six months and two-years post-operatively, while examiners recorded range of motion, strength, and presence of impingement signs. RESULTS: Results: Patients from both groups had significantly improved clinical outcomes at the two-year follow-up as compared to pre-operative values. Stiffness patients had 0/25 (0%) re-tears at two years, significantly less (p = 0.009) than the non-stiffness patients (34/170 [20%]). Range of motion was similar between groups at two-years for forward flexion, abduction and external rotation, while the non-stiffness group had a superior range of internal rotation (p < 0.02). CONCLUSION: Discussion: The good outcomes of rotator cuff repair with glenohumeral joint capsule release suggest that there is no advantage in delaying surgical repair of a rotator cuff tear to allow for stiffness to resolve. In contradistinction, the data presented in this paper suggests that shoulder stiffness with glenohumeral joint capsule release, confers an advantage in terms of repair integrity.
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spelling pubmed-49015652016-06-10 The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients McGrath, Jordan Lam, Patrick Hong Tan, Martin Murrell, George A.C. Orthop J Sports Med Article OBJECTIVES: Background: There is debate as to whether to operate or defer surgery on patients with concomitant rotator cuff tear and shoulder stiffness. The purpose of this study was, therefore, to compare the outcomes in those patients who had both their rotator cuff tear and shoulder stiffness treated with patients who had a rotator cuff repair but no stiffness. METHODS: Methods: 1232 primary arthroscopic rotator cuff repairs were performed during the study period, including 44 patients who received a concomitant glenohumeral joint capsule release for ipsilateral shoulder stiffness, forming the stiffness group. A chronologically matched group of four rotator cuff repair-only patients before and after each stiffness patient were chosen from the consecutive list of rotator cuff repairs. Twenty-five patients from the stiffness group and 170 patients from the non-stiffness group met the inclusion criteria, leaving a total cohort of 195 patients. Patients completed modified L’Insalata Questionnaires for patient-ranked pain and function scores pre-operatively, intra-operatively, and at one week, six weeks, 12 weeks, six months and two-years post-operatively, while examiners recorded range of motion, strength, and presence of impingement signs. RESULTS: Results: Patients from both groups had significantly improved clinical outcomes at the two-year follow-up as compared to pre-operative values. Stiffness patients had 0/25 (0%) re-tears at two years, significantly less (p = 0.009) than the non-stiffness patients (34/170 [20%]). Range of motion was similar between groups at two-years for forward flexion, abduction and external rotation, while the non-stiffness group had a superior range of internal rotation (p < 0.02). CONCLUSION: Discussion: The good outcomes of rotator cuff repair with glenohumeral joint capsule release suggest that there is no advantage in delaying surgical repair of a rotator cuff tear to allow for stiffness to resolve. In contradistinction, the data presented in this paper suggests that shoulder stiffness with glenohumeral joint capsule release, confers an advantage in terms of repair integrity. SAGE Publications 2015-03-23 /pmc/articles/PMC4901565/ http://dx.doi.org/10.1177/2325967115S00003 Text en © The Author(s) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
spellingShingle Article
McGrath, Jordan
Lam, Patrick Hong
Tan, Martin
Murrell, George A.C.
The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title_full The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title_fullStr The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title_full_unstemmed The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title_short The Effect Of Concomitant Glenohumeral Joint Capsule Release During Rotator Cuff Repair - A Comparative Study Of 195 Patients
title_sort effect of concomitant glenohumeral joint capsule release during rotator cuff repair - a comparative study of 195 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901565/
http://dx.doi.org/10.1177/2325967115S00003
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