Postarthroscopic Arthrofibrosis of the Shoulder

Vezeridis, Peter S.; Goel, Danny P.; Shah, Anup; Sung, Sarah; Warner, Jon J.P.

doi:10.1097/jsa.0b013e3181ec84a5

Cited by 44 publications

(32 citation statements)

References 37 publications

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“…Modified rehabilitation protocols have been developed for patients with certain risk factors for the development of a frozen shoulder, but this must be balanced by the need to avoid retears of the rotator cuff from early mobilization. 25,27 This study has several limitations, including the inherent limitations of a retrospective study, short clinical follow-up, lack of a control group for either nonoperative management or open repair of anterosuperior tears, and small sample size. However, this study provides short-term information regarding the structural integrity and functional outcomes of patients who have an anterosuperior rotator cuff tear.…”

Section: Discussionmentioning

confidence: 98%

“…The occurrence of postoperative stiffness is a well-known complication of rotator cuff surgery that reduces patient satisfaction and clinical outcomes. 24,25 Much work has been performed examining the cause of postoperative stiffness, including time of immobilization postoperatively 26 and various preoperative factors that may contribute to a loss of motion postoperatively. 24,27 Further investigation is needed with regard to postoperative stiffness after subscapularis tear repair because the low numbers seen in the current study make it difficult to draw concrete conclusions.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Treatment of Anterosuperior Rotator Cuff Tears

Schnaser¹,

Toussaint²,

Gillespie³

et al. 2013

Orthopedics

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This study evaluated pre- and postoperative clinical and structural outcome data on anterosuperior rotator cuff tears involving the supraspinatus and subscapularis treated by arthroscopic methods. Between June 2006 and October 2007, a total of 155 consecutive patients underwent an arthroscopic repair for a supraspinatus or supraspinatus and infraspinatus (superior) rotator cuff tear. Of these, 44 (28%) were identified on preoperative imaging to have involvement of the subscapularis. Confirmation of subscapularis tears occurred during arthroscopic repair of the superior rotator cuff. If the subscapularis was found to be torn, it was documented, and an arthroscopic repair was performed. Postoperative clinical and radiographic outcomes were assessed with the belly press and lift-off tests, range of motion, strength, pain score, Constant score, and either a magnetic resonance imaging arthrogram or a computed tomography arthrogram at an average of 15 months postoperatively. Failure was determined based on rotator cuff integrity on radiologic studies. Sixteen of the 44 anterosuperior rotator cuff tears identified on preoperative imaging were found to have a full-thickness subscapularis tear requiring repair on arthroscopic examination. On preoperative imaging, subscapularis tears were all either grade 1 or grade 2 (no complete grade 3 tears). Mean follow-up was 16.9 months (range, 13-24 months). Compared with preoperative values, significant postoperative improvements occurred in Constant scores, forward flexion, strength, and pain scores (P<.01). Patients also showed significant improvements in both the lift-off and belly press tests (P<.001). Mean postoperative patient satisfaction was 7.9 (range, 5-10) with 10 (59%) of 17 patients being extremely satisfied. Two of the 17 patients with an anterosuperior rotator cuff tear had confirmed retears of the supraspinatus (1 partial and 1 full-thickness) with no radiographic evidence of retear of any of the subscapularis repairs at most recent follow-up.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of Anterosuperior Rotator Cuff Tears

Schnaser¹,

Toussaint²,

Gillespie³

et al. 2013

Orthopedics

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“…However, we subsequently became aware of other studies showing that stiffness can be common after arthroscopic shoulder procedures [48–50] and that the pain after arthroscopic and open rotator cuff repairs is similar [51]. …”

Section: Discussionmentioning

confidence: 99%

Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study

et al. 2017

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IntroductionWhat is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery?MethodsRetrospective 10-year review of a shoulder surgeon’s practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire.ResultsApproximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection. Over 95% of patients stated that the injections helped reduce shoulder pain and increased function 6 weeks post-injection. Twenty-two percent of cases (208/945) received glenohumeral and/or subacromial injections. The 208 injected cases had these diagnoses: rotator cuff tear (28% of injected patients), subacromial impingement (20%), glenohumeral instability (16%), subacromial impingement with acromioclavicular osteoarthritis (10%), adhesive capsulitis (7%), SLAP lesion (5%), biceps tendinopathy (3%), glenohumeral instability with subacromial impingement (3%), proximal humerus fracture (2%), calcific tendinitis (2%), and less common conditions (4%). Diagnoses among those with the highest rates of injected patients per diagnosis included: SLAP lesions (40%), calcific tendinitis (40%), adhesive capsulitis (29%), subacromial impingement (28%), proximal humerus fracture (24%), rotator cuff tear (19%), and glenohumeral instability (16%). Significant differences (p < 0.03) were found between patients who did and did not receive injections with respect to age (more likely younger patients with cuff tear) and sex (more likely female with subacromial impingement and instability) but not for diabetes or arthroscopic vs. open procedures.ConclusionThis is the first study to establish the rates of postoperative shoulder corticosteroid injections within the first 6 months after various non-arthroplasty shoulder surgeries for patients with high pain/stiffness. These data will be useful for establishing guidelines for using corticosteroid injections along with physiotherapy.

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“…Recovery from primary adhesive capsulitis generally includes a return of motion and resolution of symptoms; however, secondary adhesive capsulitis can be more difficult to treat [9]. Postoperative adhesive capsulitis can follow a more protracted course, often requiring a surgical release procedure [5,[9][10][11][12][13][14][15]. Postoperative adhesive capsulitis can occur in up to 13% of patients after rotator cuff repair [11].…”

Section: Introductionmentioning

confidence: 99%