Summary
Concomitant arthroscopic capsular release and cuff repair in cuff tears with stiffness yields similar outcomes as repairs in cuff tears without stiffness. Hence arthroscopic capsular release can be a valuable adjunct for patients presenting with cuff tears and stiffness.
Abstract
Background
Available studies on concomitant arthroscopic capsular release(ACR) with rotator cuff repair(RCR) for cuff tears with concomitant stiffness show inconsistencies in pre-operative demographic and cuff tear parameters, cuff repair techniques, post-operative rehabilitation approaches, and assessment modalities for evaluating cuff tear healing which have the potential to impact the final outcomes.
Hypothesis
We hypothesized that patients undergoing concomitant ACR and RCR would demonstrate similar outcomes and retear rates compared to those undergoing arthroscopic repair for cuff tears without stiffness.
Study design: Ambidirectional cohort study, Level III Study
Methods
This study included patients operated between Jan 2017 and December 2021 who were prospectively followed up for functional evaluation and MRI imaging. Propensity score matching was done at 1:2 ratio, meaning that for every patient in group 1(ACR+RCR)(n=33), we selected two patients in group 2(RCR)(n=66) with similar propensity scores. Clinical assessment was done in terms of range of motion (ROM), Visual analog score, Constant score & American Shoulder Elbow Surgeons. MRI analysis was done at a minimum of 6 months postoperatively to assess cuff healing.
Results
Post operatively, there was significant improvement in VAS, ROM & functional scores(p<0.05) in patients undergoing concomitant arthroscopic cuff repair and capsular release which was comparable to patients undergoing cuff repair alone at mean final follow-up of 2.8 and 3.2 years respectively. Retear rate was 12%(4/33) & 13/66(19.7%) in Group I & II respectively, the difference being statistically insignificant(p=0.3).
Conclusion
Concomitant arthroscopic capsular release and cuff repair in cuff tears with stiffness yields similar outcomes as repairs in cuff tears without stiffness. Hence arthroscopic capsular release can be a valuable adjunct for patients presenting with cuff tears and stiffness.