Influence of Small-and Medium-sized Rotator Cuff Tears Combined With or Without Shoulder Joint Adhesion on Shoulder Joint Function After Arthroscopic Surgery
10.3969/j.issn.1009-6604.2025.07.006
- VernacularTitle:中小肩袖撕裂合并肩关节粘连与否对关节镜术后肩关节功能的影响
- Author:
Wenjie WU
1
;
Yu MEI
1
;
Hui YAN
1
Author Information
1. 北京大学第三医院运动医学科,北京 100191
- Publication Type:Journal Article
- Keywords:
Rotator cuff tear;
Shoulder joint adhesion;
Arthroscopy;
Repair surgery
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(7):416-422
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the difference in the mid-term efficacy of arthroscopic treatment for small-and medium-size(≤3 cm)rotator cuff tears combined with or without shoulder joint adhesion.Methods A retrospective analysis was conducted on the clinical data of 254 cases of small-and medium-size rotator cuff tears treated by arthroscopy in our department from January 2018 to January 2023 and followed up for more than one year.Among them,86 cases were combined with shoulder joint adhesion,and 168 cases were not combined with shoulder joint adhesion.A total of 81 pairs of data were obtained through propensity score matching(PSM).The shoulder joint pain and functional scores at the last follow-up of the two groups were compared,including the Visual Analogue Scale(VAS)for pain,the American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley score,and shoulder joint score of the University of California at Los Angeles(UCLA).The rotator cuff healing and retearing rate were evaluated by using the range of motion of the shoulder joint and the Sugaya classification of MR.Results The follow-up time of the shoulder joint adhesion group and the non-shoulder joint adhesion group was(42.2±13.0)months and(44.7±14.2)months,respectively(P=0.248).The preoperative VAS score,ASES score,Constant-Murley score and UCLA score in the shoulder joint adhesion group were all worse than those in the non-shoulder joint adhesion group(P<0.01).At the last follow-up,the VAS scores,ASES scores,Constant-Murley scores and UCLA scores of both groups were significantly improved compared with those before the operation(P<0.001),and there was no significant difference between the two groups(P>0.05).The angles of anterior flexion,abduction,lateral internal rotation and lateral external rotation of the shoulder joint in the shoulder joint adhesion group before the operation were all smaller than those in the non-shoulder joint adhesion group(P<0.001).At the last follow-up,the four ranges of motion of the shoulder joint in both groups were significantly larger than those before the operation(P<0.01),and the shoulder joint adhesion group was still worse than the non-shoulder joint adhesion group(P<0.05).There was no rotator cuff retear(Sugaya type Ⅳ and typeⅤ)in both groups.The proportion of Sugaya type Ⅰ in the shoulder joint adhesion group at the last follow-up was lower than that in the non-shoulder joint adhesion group[21.0%(17/81)vs.60.5%(49/81),P<0.001].Conclusions Arthroscopic rotator cuff repair and joint capsule release surgery for patients with small-and medium-size rotator cuff tears combined with shoulder joint adhesion can relieve shoulder joint pain.The shoulder joint function score at the mid-term follow-up is similar to that of those without shoulder joint adhesion.Although the range of motion of the shoulder joint is significantly improved compared with that before the operation,it still could not reach the level of those without shoulder joint adhesion.
