- Email: [email protected]
Characteristics of the Patients with Rotator Cuff Tears with Stiffness
2017 ISAKOS ABSTRACTS
from prior to surgery. For patients with pre-operative UCLA scores, scores were significantly higher at mid-term and long-term follow-up. Patients who were less than eight years since surgery had significantly higher SST and UCLA scores than those who were eight to ten years since surgery. Patients who were 2 to 4 years since surgery had higher SST scores than those greater than 4 years since surgery. There were no significant differences in pre-operative radiographic classifications and outcome; however there was a trend toward significance between UCLA score and Samilson and Prieto classification. 82.1% of respondents stated that were the surgery indicated for their contralateral shoulder, they would undergo to the surgery again. Conclusion: Arthroscopic debridement with capsular release for patients with painful shoulder idiopathic osteoarthritis with limitations in motion demonstrate good clinical efficacy up to 10 years after surgery with minimal surgical risk for the patient. Category: Shoulder - Rotator Cuff Paper #255: Characteristics of the Patients with Rotator Cuff Tears with Stiffness SATOSHI IWASHITA, MD, JAPAN HIROSHI HASHIGUCHI, MD, PHD, JAPAN MINORU YONEDA, MD, DMSC, JAPAN SHINRO TAKAI, MD, PHD, JAPAN Nippon Medical School, Tokyo, JAPAN SUMMARY The differences between RCT with stiffness and RCT without stiffness have not yet been revealed sufficiently, therefore we analyzed characteristics of the patients with RCT with stiffness and suggested that RCT with stiffness is more frequently observed in smoker, young patients, patients with atraumatic history and partial thickness tears. ABSTRACT DATA Background: We frequently treat with rotator cuff tears (RCT) with stiffness. However, the differences between RCT with stiffness and RCT without stiffness have not yet been revealed sufficiently. The purpose of this study was to analyze characteristics of the patients with RCT with stiffness. Method: 303 patients with rotator cuff tears treated by arthroscopic rotator repair were the subjects of this study. There were 154 females and 149 males whose average age was 63.1 years. 123 patients had history of trauma. The average duration of disorder was 32.5 weeks. 48 patients were diagnosed as diabetes. Smokers were observed in 19 patients. On types of the tears, articular side tear was observed in 60 patients, bursal side tear in 43 patients, small tear in 93 patients, medium tear in 75 patients, large tear in 14 patients, massive tear in 18 patients. Shoulder with restricted ROM (passive flexion range of motion < 90 degrees, external rotation < 30 degrees, internal rotation < fifth lumbar vertebra ) was defined as stiff shoulder. Factors compared between RCT with stiffness and RCT without stiffness were as follows; gender and age of the patients, preoperative history of trauma, duration of disorder, diabetes, smoking, and type of tears. All data were evaluated statistically by t-test and chi-square test and the significance level was set at less than 0.05.
e167
Results: RCT with stiffness were observed in 53 patients. The patient with stiffness were younger than the patients without stiffness. The rate of trauma of the patients without stiffness was significantly higher than that of the patients with stiffness. Smokers were observed more significantly in the patients with stiffness than in the patients without stiffness. The rate of stiff shoulder in the patients with partial thickness rotator cuff tears was significantly higher than that in the patients with full thickness rotator cuff tears. The other factors such as gender, duration of disorder and diabetes were not significantly different between the patients with stiffness and without stiffness. Conclusion: This study suggests that RCT with stiffness is more frequently observed in smoker, young patients, patients with atraumatic history and partial thickness tears. Cytokine, autonomic reflex, decrease of joint fluid, tear of coracohumeral ligament and nicotine may contribute stiffness.
Category: Shoulder - Rotator Cuff Paper #256: Outcomes Following Surgical Treatment for Rotator Cuff Tears with Adhesive Capsulitis are Equivalent to Surgical Treatment for Rotator Cuff Tears Alone: A Systematic Review SOHEIL SABZEVARI, MD, UNITED STATES AMIR REZA KACHOOEI JUAN GIUGALE, MD, UNITED STATES ALBERT LIN, MD, UNITED STATES University of Pittsburgh Medical Center, Pittsburgh, PA, UNITED STATES
SUMMARY One stage surgical treatment of rotator cuff tears with preoperative adhesive capsulitis has comparable results to surgical treatment of rotator cuff tears without adhesive capsulitis. ABSTRACT DATA Introduction: Rotator cuff tears with concomitant adhesive capsulitis is a challenging clinical scenario. Addressing preoperative adhesive capsulitis prior to rotator cuff repair is sometimes advocated but whether this approach improves outcomes is controversial. Some authors have reported satisfactory outcomes after onestage treatment of rotator cuff repair and simultaneous manipulation under anesthesia, with and without capsular release. In this systematic review, we compare range of motion and functional outcomes of combined surgical treatment of RCT and adhesive capsulitis versus the treatment of isolated RCT without shoulder stiffness. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we searched the databases including MEDLINE, EMBASE, Cochrane Library, and Scopus using the keywords of “shoulder stiffness” and/or “adhesive capsulitis” and/or “frozen shoulder” with “rotator cuff tear”. We included studies that only met all 3 following criteria: 1) compared
from prior to surgery. For patients with pre-operative UCLA scores, scores were significantly higher at mid-term and long-term follow-up. Patients who were less than eight years since surgery had significantly higher SST and UCLA scores than those who were eight to ten years since surgery. Patients who were 2 to 4 years since surgery had higher SST scores than those greater than 4 years since surgery. There were no significant differences in pre-operative radiographic classifications and outcome; however there was a trend toward significance between UCLA score and Samilson and Prieto classification. 82.1% of respondents stated that were the surgery indicated for their contralateral shoulder, they would undergo to the surgery again. Conclusion: Arthroscopic debridement with capsular release for patients with painful shoulder idiopathic osteoarthritis with limitations in motion demonstrate good clinical efficacy up to 10 years after surgery with minimal surgical risk for the patient. Category: Shoulder - Rotator Cuff Paper #255: Characteristics of the Patients with Rotator Cuff Tears with Stiffness SATOSHI IWASHITA, MD, JAPAN HIROSHI HASHIGUCHI, MD, PHD, JAPAN MINORU YONEDA, MD, DMSC, JAPAN SHINRO TAKAI, MD, PHD, JAPAN Nippon Medical School, Tokyo, JAPAN SUMMARY The differences between RCT with stiffness and RCT without stiffness have not yet been revealed sufficiently, therefore we analyzed characteristics of the patients with RCT with stiffness and suggested that RCT with stiffness is more frequently observed in smoker, young patients, patients with atraumatic history and partial thickness tears. ABSTRACT DATA Background: We frequently treat with rotator cuff tears (RCT) with stiffness. However, the differences between RCT with stiffness and RCT without stiffness have not yet been revealed sufficiently. The purpose of this study was to analyze characteristics of the patients with RCT with stiffness. Method: 303 patients with rotator cuff tears treated by arthroscopic rotator repair were the subjects of this study. There were 154 females and 149 males whose average age was 63.1 years. 123 patients had history of trauma. The average duration of disorder was 32.5 weeks. 48 patients were diagnosed as diabetes. Smokers were observed in 19 patients. On types of the tears, articular side tear was observed in 60 patients, bursal side tear in 43 patients, small tear in 93 patients, medium tear in 75 patients, large tear in 14 patients, massive tear in 18 patients. Shoulder with restricted ROM (passive flexion range of motion < 90 degrees, external rotation < 30 degrees, internal rotation < fifth lumbar vertebra ) was defined as stiff shoulder. Factors compared between RCT with stiffness and RCT without stiffness were as follows; gender and age of the patients, preoperative history of trauma, duration of disorder, diabetes, smoking, and type of tears. All data were evaluated statistically by t-test and chi-square test and the significance level was set at less than 0.05.
e167
Results: RCT with stiffness were observed in 53 patients. The patient with stiffness were younger than the patients without stiffness. The rate of trauma of the patients without stiffness was significantly higher than that of the patients with stiffness. Smokers were observed more significantly in the patients with stiffness than in the patients without stiffness. The rate of stiff shoulder in the patients with partial thickness rotator cuff tears was significantly higher than that in the patients with full thickness rotator cuff tears. The other factors such as gender, duration of disorder and diabetes were not significantly different between the patients with stiffness and without stiffness. Conclusion: This study suggests that RCT with stiffness is more frequently observed in smoker, young patients, patients with atraumatic history and partial thickness tears. Cytokine, autonomic reflex, decrease of joint fluid, tear of coracohumeral ligament and nicotine may contribute stiffness.
Category: Shoulder - Rotator Cuff Paper #256: Outcomes Following Surgical Treatment for Rotator Cuff Tears with Adhesive Capsulitis are Equivalent to Surgical Treatment for Rotator Cuff Tears Alone: A Systematic Review SOHEIL SABZEVARI, MD, UNITED STATES AMIR REZA KACHOOEI JUAN GIUGALE, MD, UNITED STATES ALBERT LIN, MD, UNITED STATES University of Pittsburgh Medical Center, Pittsburgh, PA, UNITED STATES
SUMMARY One stage surgical treatment of rotator cuff tears with preoperative adhesive capsulitis has comparable results to surgical treatment of rotator cuff tears without adhesive capsulitis. ABSTRACT DATA Introduction: Rotator cuff tears with concomitant adhesive capsulitis is a challenging clinical scenario. Addressing preoperative adhesive capsulitis prior to rotator cuff repair is sometimes advocated but whether this approach improves outcomes is controversial. Some authors have reported satisfactory outcomes after onestage treatment of rotator cuff repair and simultaneous manipulation under anesthesia, with and without capsular release. In this systematic review, we compare range of motion and functional outcomes of combined surgical treatment of RCT and adhesive capsulitis versus the treatment of isolated RCT without shoulder stiffness. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we searched the databases including MEDLINE, EMBASE, Cochrane Library, and Scopus using the keywords of “shoulder stiffness” and/or “adhesive capsulitis” and/or “frozen shoulder” with “rotator cuff tear”. We included studies that only met all 3 following criteria: 1) compared