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Archives of Orthopaedic and Traumatic Surgery
Article . 2021 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Treatment of partial rotator cuff lesions is associated with a higher frequency of post-operative shoulder stiffness. A prospective investigation on the role of surgery-related risk factors for this complication

Authors: Davide Cucchi; Alessandra Menon; Sonia Maggi; Francesca Maria Feroldi; Annalisa De Silvestri; Max Julian Friedrich; Matthias Dominik Wimmer; +1 Authors

Treatment of partial rotator cuff lesions is associated with a higher frequency of post-operative shoulder stiffness. A prospective investigation on the role of surgery-related risk factors for this complication

Abstract

Abstract Purpose Post-operative shoulder stiffness (SS) is a common complication after arthroscopic rotator cuff (RC) repair. The aim of this prospective study is to evaluate the role of surgical risk factors in the development of this complication, with special focus on the characteristics of the RC tears. Methods Two-hundred and twenty patients who underwent arthroscopic RC repair for degenerative posterosuperior RC tears were included. Surgery-related risk factors for development of post-operative SS belonging to the following five categories were documented and analyzed: previous surgery, RC tear characteristics, hardware and repair type, concomitant procedures, time and duration of surgery. The incidence of post-operative SS was evaluated according to the criteria described by Brislin and colleagues. Results The incidence of post-operative SS was 8.64%. The treatment of partial lesions by tear completion and repair technique was significantly associated with development of post-operative SS (p = 0.0083, pc = 0.04). A multivariate analysis revealed that treatment of partial lesions in patients younger than 60 years was associated to a higher risk of developing post-operative SS (p = 0.007). Previously known pre-operative risk factors such as female sex and younger age were confirmed. No other significant associations were documented. Conclusion The treatment of partial lesions of the RC may lead to a higher risk of post-operative SS than the treatment of complete lesions, in particular in patients younger than 60 years. Possible explanations of this finding are the increased release of pro-inflammatory cytokines caused by the additional surgical trauma needed to complete the lesion and the different pain perception of the subgroup of patients who require surgical treatment already for partial tears. Evidence A higher risk of post-operative SS should be expected after tear completion and repair of partial lesions, especially in young patients. Appropriate pre-operative counseling and post-operative rehabilitation should be considered when approaching this subgroup of RC tears. Level of evidence Prognostic study, level II.

Country
Germany
Keywords

Rupture, Shoulder, Rotator Cuff Injuries, Rotator Cuff Injuries/surgery [MeSH] ; Arthroscopy/methods [MeSH] ; Female [MeSH] ; Shoulder ; Shoulder stiffness ; Rotator Cuff/surgery [MeSH] ; Humans [MeSH] ; Prospective Studies [MeSH] ; Treatment Outcome [MeSH] ; Cytokines [MeSH] ; Joint Diseases [MeSH] ; Partial tear ; Risk Factors [MeSH] ; Arthroscopy and Sports Medicine ; Adhesive capsulitis ; Rotator cuff repair ; Range of Motion, Articular [MeSH] ; Shoulder [MeSH] ; Arthroscopy/adverse effects [MeSH] ; Rupture [MeSH] ; Arthroscopy ; Frozen shoulder, Arthroscopy, Rotator Cuff, Arthroscopy and Sports Medicine, Treatment Outcome, Risk Factors, Adhesive capsulitis; Arthroscopy; Frozen shoulder; Partial tear; Rotator cuff repair; Shoulder; Shoulder stiffness;, Cytokines, Humans, Female, Prospective Studies, Joint Diseases, Range of Motion, Articular

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
9
Top 10%
Average
Average
Green
hybrid