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Objective(s)
To determine the incidence of postoperative shoulder stiffness (POSS) after arthroscopic
rotator cuff repair (ARCR) for partial and full thickness rotator cuff tears to help
orthopedic surgeons and physical therapists improve patient outcomes and reduce complications.
Data Sources
A systematic review was performed using PubMed, CINAHL, MEDLINE, and ScienceDirect
databases without time restrictions. Full search terms were “Rotator cuff repair”
AND “Arthrofibrosis” OR “Postoperative shoulder stiffness.”
Study Selection
A total of 284 articles were retrieved and 25 articles met final selection criteria.
Articles were selected based on arthroscopic rotator cuff repair and presence of POSS
of any type or severity. POSS was defined as reported postoperative stiffness, postoperative
arthrofibrosis, and postoperative adhesive capsulitis. Studies with evidence of Level
I to IV were included. Studies were excluded if they did not report POSS incidence
in the study population, did not report postoperative complications, or if the repair
was not arthroscopic.
Data Extraction
Articles were examined for full text and relevance for total number of patients, type
of arthroscopic rotator cuff repair, and number of patients with POSS. Data Extraction
occurred by multiple observers.
Data Synthesis
Twenty-five articles were chosen after review for patients (n=9,373) who underwent
ARCR. Out of the 9,373 patients who underwent ARCR, 597 patients reported POSS (6.37%).
Of the 2,424 patients with specified tear pattern, 96 out of 1862 (5.2%) patients
with full thickness tears had POSS and 58 out of 562 (10.3%) patients with partial
thickness tears had POSS. ARCR for partial thickness tear had a significantly higher
incidence for POSS as compared to ARCR for full thickness tear (p< 0.01).
Conclusions
Postoperative shoulder stiffness is a common complication after arthroscopic rotator
cuff repair with an overall incidence of 6.4%. POSS was more common after ARCR for
partial tears as compared to ARCR for full thickness tears. Further research is needed
to determine more factors contributing to POSS after ARCR.
Author(s) Disclosures
None of the authors have any significant conflicts to disclose.
Key Words
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Copyright
© 2022 Published by Elsevier Inc.
