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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.
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.”
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.
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.
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).
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.
None of the authors have any significant conflicts to disclose.
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