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No benefits observed for delayed surgical repair of torn rotator cuff
LAS VEGAS — Rotator cuff repair using glenohumeral joint capsule release demonstrated good outcomes, indicating there is no need to delay rotator cuff tear repair surgery to allow stiffness to heal, according to a speaker at the American Academy of Orthopaedic Surgeons Annual Meeting, here.
“In the past, many surgeons have elected to wait until stiffness has resolved in patients with rotator cuff tears and stiffness, for fear of making the shoulder worse,” George A. C. Murrell, MD, PhD, told Healio.com/orthopedics. “This research shows that the opposite is true: if you repair the rotator cuff in the presence of stiffness, the chances of getting a good outcome are much greater.”
Murrell and colleagues retrospectively compared 170 patients who had stiffness after rotator cuff repair with 25 patients who had no stiffness after rotator cuff repair, using modified L’Insalata Questionnaires to evaluate patient-ranked pain and function scores preoperatively, intraoperatively and postoperatively at 1 week, 6 weeks, 12 weeks, 6 months and 2 years. Range of motion, strength and the presence of signs of impingement were also recorded.
George A. C. Murrell
“Our cohort of patients who had a capsular release [for stiffness] and a rotator cuff repair had a healing rate of 100% at 6 months — for example, no retears,” Murrell said. “This is the first study I have done, and I suspect that anyone else has done, where there were no retears after rotator cuff repair.”
Forward flexion, abduction and external rotation range of motion were similar in both groups, but range of internal rotation was superior in the non-stiffness cohort, according to the researchers. ‒ by Monica Jaramillo
Reference: McGrath J, et al. Paper #13. Presented at: American Orthopaedic Society for Sports Medicine Specialty Day; March 28,2015; Las Vegas
Disclosures: Murrell reports he receives royalties and financial support from Novan, is a paid consultant for Arthocare, and receives support from Arthocare and Arthrex. Please see the full abstract for a list of all other authors’ relevant financial disclosures.