Postoperative outcomes of arthroscopic subacromial decompression for rotator cuff tear with shoulder stiffness.
Some patients with rotator cuff tear have shoulder stiffness preoperatively. Concomitant preoperative shoulder stiffness may affect postoperative outcomes of arthroscopic subacromial decompression (ASD) for rotator cuff tear. The purpose of this study was to compare postoperative outcomes for ASD between rotator cuff tear patients with and without preoperative shoulder stiffness and to analyze the serial change in functional scores, range of motion (ROM), and pain intensity of the 2 groups after operation. 60 shoulders of 58 patients who underwent ASD for rotator cuff tear were studied. Arthroscopic release was performed for the stiffness group. The results were assessed before surgery and 1, 3, 6, 12 and 24 months after surgery, and the results in the stiffness group and non-stiffness group were compared.  No differences in serial changes for postoperative outcomes of ASD were seen in terms of the Japanese Orthopaedic Association shoulder scoring system (JOA scores) and the visual analog scale (VAS scores) for pain at night and pain during motion between the stiffness group and non-stiffness group. However, compared to the non-stiffness group, forward flexion and abduction angles were significantly smaller for the stiffness group at 1 and 3 months after surgery. External rotation and internal rotation angles were significantly smaller at 1 month after surgery for the stiffness group than for the non-stiffness group.  Preoperative shoulder stiffness does not affect improvement of postoperative JOA scores and VAS scores of ASD. When measured 6 months after surgery, ROM in the stiffness group and the non-stiffness group was similar.
Department of Orthopedic Surgery, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, Japan. shishi-h@fmu.ac.jp
Hiroaki
H
Shishido
Shinichi
S
Kikuchi
Kenichi
K
Otoshi
Shinichi
S
Konno
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology*; D011184:Postoperative Period; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D012782:Shoulder / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome