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Study finds patients rapidly recover from stiffness following arthroscopic shoulder surgery
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Though stiffness in postoperative range of motion in patients is common following arthroscopic shoulder surgery, the stiffness will usually recede without the need for additional surgery, according to a recent study in Shoulder & Elbow.
Researchers graded patient stiffness severity from 0 to 3 in 234 consecutive arthoscopic procedures over 12 months. Stiffness was compared to the range of motion (ROM) on the opposite limb and the time needed to fully regain ROM was recorded, according to the abstract. A loss of one-third ROM was labeled Grade 1, from one-third to two-thirds movement loss was Grade 2 and function loss greater than two-thirds was deemed Grade 3 stiffness.
Four patients needed active intervention to recover from stiffness, while the rest of the group recovered within the 12-month period, according to the abstract. Within 3 months, 63% of patients had full function; 94% of patients within 6 months and 97% of patients within 12 months regained function. Researchers said patient stiffness was related to preoperative diagnosis.
Within the stiffness grades, 85% of patients with Grade 1 stiffness returned to full ROM within 6 months. Patients with Grade 2 and 3 stiffness were less likely to regain full ROM, at 43%, according to the abstract.
Perspective
Back to TopRonald A. Navarro, MD
The authors in this study reiterate a happy fact that stiffness after shoulder arthroscopic procedures is relatively rare. While the rate of postoperative shoulder stiffness has been described as anywhere from 3% to 9% in multiple journals after arthroscopic rotator cuff repair, this article describes a 1.7% rate (4/234) of “active intervention” for recovery due to stiffness after multiple different shoulder arthroscopic procedure types. Presumably, this would mean that operative intervention occurred.
Many shoulder surgeons would include patients who never regained full range of motion (ROM) but didn’t receive a second operative intervention in the postoperative stiffness category. The three level grading for ROM is novel, but it is unclear from the abstract if comparison to the opposite side is for total summed range or for a single plane of ROM. From review of the abstract, the cohort included multiple diagnostic types.
I would urge the authors to continue their studies and eventually separate the treatment groups so a rate by shoulder surgical class or diagnostic type can be discerned. The full value of their work will be realized by helping other surgeons to accurately predict patients who might be at increased risk for postoperative stiffness after shoulder arthroscopy.
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