title: Arthroscopic treatment of rotator cuff tears with shoulder stiffness: a comparison of functional outcomes with and without capsular release.
abstract: BACKGROUND
  In a single arthroscopic surgery for rotator cuff tears with a stiff shoulder, closed manipulation with or without arthroscopic capsular release has been combined with the repair. Few studies have reported functional results after this surgery, and a clinical comparison has not been reported.
  
  
  OBJECTIVE
  To compare functional outcomes with and without capsular release in arthroscopic treatment of rotator cuff tears with a stiff shoulder.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Among patients who underwent arthroscopic rotator cuff repairs with a concomitant stiff shoulder, 34 patients were treated with either manipulation and arthroscopic capsular release (group A; n = 18) or manipulation without capsular release (group B; n = 16). Preoperative mean passive forward flexion was 118° in group A and 117° in group B, whereas external rotation at the side was 28° and 29°, respectively. All patients were evaluated at a minimum 2-year follow-up in terms of visual analog scale for pain, muscle power, range of motion, Constant score, modified American Shoulder and Elbow Surgeons (ASES) shoulder evaluation form, and modified University of California at Los Angeles (UCLA) scores.
  
  
  RESULTS
  The mean modified ASES score was 90.3 for group A and 87.7 for group B (P = .086). The mean UCLA scores were 34.3 and 33.0, respectively (P = .247). The 2 groups showed a significant difference in forward flexion and external rotation post operatively, as group B recovered more slowly. There was no difference in the mean visual analog scale for pain at the last follow-up, but a 13° difference in forward flexion (P < .001) and a 10° difference in external rotation (P =.001) were seen.
  
  
  CONCLUSIONS
  Overall satisfactory results could be achieved by either method, whereas rapid recovery and improvement of range of motion could be achieved by using a single arthroscopic repair and concomitant release for patients with rotator cuff tears with stiff shoulder.
authors: Department of Orthopedic Surgery, Taipei Medical University-Wan Fang Hospital, 9f, 10-5, Smart Family, Liyuan 2nd St, Linkou Township, Taipei County, Taiwan 244. ctycgmh@gmail.com
authors: Tai-Yuan
authors: TY
authors: Chuang
authors: Wei-Pin
authors: WP
authors: Ho
authors: Chih-Hwa
authors: CH
authors: Chen
authors: Chian-Her
authors: CH
authors: Lee
authors: Jiann-Jong
authors: JJ
authors: Liau
authors: Chang-Hung
authors: CH
authors: Huang
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D057913:Joint Capsule Release; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome