Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness

BACKGROUND: To compare the clinical outcomes of one-stage and two-stage procedures for the management of patients with rotator cuff tear and concomitant shoulder stiffness. METHODS: From December 2013 to June 2016, we recruited 42 consecutive patients with rotator cuff tear and concomitant shoulder...

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Autores principales: Zhuo, Hongwu, Li, Jian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367837/
https://www.ncbi.nlm.nih.gov/pubmed/30732637
http://dx.doi.org/10.1186/s13018-019-1075-3
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author Zhuo, Hongwu
Li, Jian
author_facet Zhuo, Hongwu
Li, Jian
author_sort Zhuo, Hongwu
collection PubMed
description BACKGROUND: To compare the clinical outcomes of one-stage and two-stage procedures for the management of patients with rotator cuff tear and concomitant shoulder stiffness. METHODS: From December 2013 to June 2016, we recruited 42 consecutive patients with rotator cuff tear and concomitant shoulder stiffness. Twenty-two patients underwent a one-stage procedure, including arthroscopic capsule release and concomitant rotator cuff repair, within 2 weeks of the diagnosis. For the remaining twenty patients, conservative treatment for the recovery of range of motion (ROM) was initially performed before arthroscopic rotator cuff repair. The ROM, visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and satisfaction rate were assessed preoperatively; 3, 6, 12, and 24 months after surgery; and at final follow-up. RESULTS: The mean follow-up period was 26.3 months (range, 24–33 months). No significant difference was noted in preoperative demographic data (age, sex, dominant/non-dominant, diabetes mellitus, thyroid disease, and duration of symptoms) between the two groups (P = 0.165, P = 0.580, P = 0.662, P = 0.716, P = 0.231, and P = 0.152, respectively). After treatment, all patients exhibited significant improvement in ROM and functional scores (P = 0.001 and P = 0.001, respectively). At 3 months postoperatively, the two-stage group exhibited significantly improved forward flexion and internal rotation compared with the one-stage group (P = 0.001 and P = 0.038, respectively). No significant difference in ROM was noted between the two groups at 6, 12, 24 months postoperatively and the final follow-up. In addition, no significant differences in VAS, ASES, Constant-Murley score and satisfaction rate were noted between the two groups at final follow-up (P = 0.319, P = 0.529, P = 0.711, and P = 0.085, respectively). CONCLUSION: In the treatment of rotator cuff tear with concomitant stiffness, although the recovery of ROM took longer in patients who underwent the one-stage procedure, satisfactory results at final follow-up can be achieved using either the one-stage procedure or two-stage procedure. STUDY DESIGN: Case-control study.
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spelling pubmed-63678372019-02-15 Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness Zhuo, Hongwu Li, Jian J Orthop Surg Res Research Article BACKGROUND: To compare the clinical outcomes of one-stage and two-stage procedures for the management of patients with rotator cuff tear and concomitant shoulder stiffness. METHODS: From December 2013 to June 2016, we recruited 42 consecutive patients with rotator cuff tear and concomitant shoulder stiffness. Twenty-two patients underwent a one-stage procedure, including arthroscopic capsule release and concomitant rotator cuff repair, within 2 weeks of the diagnosis. For the remaining twenty patients, conservative treatment for the recovery of range of motion (ROM) was initially performed before arthroscopic rotator cuff repair. The ROM, visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and satisfaction rate were assessed preoperatively; 3, 6, 12, and 24 months after surgery; and at final follow-up. RESULTS: The mean follow-up period was 26.3 months (range, 24–33 months). No significant difference was noted in preoperative demographic data (age, sex, dominant/non-dominant, diabetes mellitus, thyroid disease, and duration of symptoms) between the two groups (P = 0.165, P = 0.580, P = 0.662, P = 0.716, P = 0.231, and P = 0.152, respectively). After treatment, all patients exhibited significant improvement in ROM and functional scores (P = 0.001 and P = 0.001, respectively). At 3 months postoperatively, the two-stage group exhibited significantly improved forward flexion and internal rotation compared with the one-stage group (P = 0.001 and P = 0.038, respectively). No significant difference in ROM was noted between the two groups at 6, 12, 24 months postoperatively and the final follow-up. In addition, no significant differences in VAS, ASES, Constant-Murley score and satisfaction rate were noted between the two groups at final follow-up (P = 0.319, P = 0.529, P = 0.711, and P = 0.085, respectively). CONCLUSION: In the treatment of rotator cuff tear with concomitant stiffness, although the recovery of ROM took longer in patients who underwent the one-stage procedure, satisfactory results at final follow-up can be achieved using either the one-stage procedure or two-stage procedure. STUDY DESIGN: Case-control study. BioMed Central 2019-02-07 /pmc/articles/PMC6367837/ /pubmed/30732637 http://dx.doi.org/10.1186/s13018-019-1075-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zhuo, Hongwu
Li, Jian
Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title_full Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title_fullStr Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title_full_unstemmed Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title_short Comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
title_sort comparison of one-stage versus two-stage procedure for the management of patients with rotator cuff tear and concomitant shoulder stiffness
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367837/
https://www.ncbi.nlm.nih.gov/pubmed/30732637
http://dx.doi.org/10.1186/s13018-019-1075-3
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