Shoulder stiffness and rotator cuff repair

Abstract

The post-operative rehabilitation protocol remains controversial. We are still far from definitive guidelines for the management of pre- and post-operative stiffness, and prospective double-blinded randomized clinical trials are needed to obtain evidence allowing to establish a reliable and effective management plan for shoulder stiffness.

Clinical Outcomes of Rotator Cuff Repair With Arthroscopic Capsular Release and Manipulation for Rotator Cuff Tear With Stiffness: A Matched-Pair Comparative Study Between Patients With and Without Stiffness

“…1,4,8,[18][19][20] However, the definition of shoulder stiffness is one of the controversial points, and authors have used different definitions. 16 Furthermore, the incidence and magnitude of the problem, as well as the treatment protocol, have not been thoroughly studied. In our series the prevalence of preoperative shoulder stiffness in patients undergoing rotator cuff repair was 14.5% (26 of 179 patients).…”

“…They concluded that overall satisfactory results could be achieved by either method, whereas rapid recovery and improvement of ROM could be achieved by using a single arthroscopic rotator cuff repair and concomitant capsular release in patients with rotator cuff tears and shoulder stiffness. In a systemic review, Papalia et al 16 reported evidence in favor of surgical management of rotator cuff tears with concomitant shoulder stiffness. In addition, there was strong evidence that arthroscopic capsular release is reliable and effective in managing shoulder stiffness.…”

“…4 The uncertainty regarding the cause of preoperative shoulder stiffness accompanying rotator cuff tears does not allow surgeons to establish whether and when a patient will recover from pain and disability after rotator cuff repair. 16 Shoulder stiffness has been problematic because it may interfere with postoperative rehabilitation after rotator cuff repair and affect postoperative clinical outcomes. Recently, however, several studies have reported that 1-stage rotator cuff repair and manipulation with or without arthroscopic capsular release were performed in patients with rotator cuff tears and shoulder stiffness.…”

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

“…Consequently, it is not surprising that patients with rotator cuff repairs were commonly injected. In fact, a recent literature review by Papalia et al [41] shows that excessive postoperative stiffness after rotator cuff repair can occur in up to 33% of cases. In turn, patients with shoulder stiffness require a longer period of time to achieve postoperative return of function, and patients with severe preoperative stiffness have a higher rate of poor outcomes after rotator cuff repair [42, 43].…”

Review: Complications of Rotator Cuff Surgery

“…Çalışmalarda, rotator manşet onarımı sonrası görülen omuz sertliği %4,8 ile %8,7 oranında bildirilmiştir (19,42,60) . Cerrahi öncesi hareket kısıtlılığı olması, rotator manşet yırtığının büyüklüğü, 50 yaştan küçük olma, PASTA yırtıkları, tek tendon onarımı omuz katılığı gelişimine predispozan faktör-ler arasındadır (61) . Bazı hastalarda görülen cerrahi ön-cesi hareket kısıtlılığı nedeni ile bazı yazarlar bunu bir komplikasyon olarak görmezler.…”