Effects of steroid injection during rehabilitation after arthroscopic rotator cuff repair

Background: Many patients fail to reap the benefits of rehabilitation after arthroscopic rotator cuff repair (ARCR) due to severe stiffness and pain. Thus, this study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after ARCR.Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography.Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.

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Paper 40: Arthroscopic Rotator Cuff Repair: Prospective Functional Outcome and Repair Integrity at Minimum 2-Year Follow-up

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2012.05.052 ◽

2012 ◽

Vol 28 (8) ◽

pp. e202

Keyword(s):

Rotator Cuff ◽

Functional Outcome ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

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Biceps Tenodesis Combined With Rotator Cuff Repair Increases Functional Status And Elbow Strength In Both Operated And Contralateral Arms

10.21203/rs.3.rs-94002/v1 ◽

2020 ◽

Author(s):

Ali Ihsan KILIC ◽

Onur HAPA ◽

Ramadan OZMANEVRA ◽

Nihat Demirhan DEMIRKIRAN ◽

Onur GURSAN

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Constant Score ◽

Elbow Flexion ◽

Arthroscopic Rotator Cuff Repair ◽

Biceps Tenodesis ◽

Significant Difference ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Abstract Purpose: Aim of the present study was to prospectively evaluate the elbow flexion and supination strengths, and the functional outcomes of patients after arthroscopic rotator cuff repair combined with simultaneous biceps tenodesis.Methods: Nineteen patients who underwent arthroscopic rotator cuff repair and biceps tenodesis with at least 24 months follow-up were included. Patients were evaluated using a visual analogue scale (VAS) for bicipital groove pain, American Shoulder and Elbow Surgeons (ASES), and constant scores(CS), biceps apex distance (BAD), elbow flexion and supination strengths.Results: VAS for biceps groove measurement averages of postoperative 6th, 12th and 24th month were lower in comparison to pre-operative data and were considered to be statistically significant (p<0.05). Constant score, an average of all post-operative measurements and scores were found higher than pre-operative values and was considered to be statistically significant (p<0,01). There was a significant difference in the comparison of operated and contralateral forearm supination and elbow flexion muscle strength measurements at postoperative 3rd and 6th-month follow-up (p<0.01).Conclusion: Arthroscopic biceps tenodesis into the anchors of lateral row combined rotator cuff repair provides an increase in strength of elbow flexion and forearm supination, while decreases pain. Level of Evidence: Level IV

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Tear size, general health status and smoking influence functional outcome at 5 years following arthroscopic rotator cuff repair

Shoulder & Elbow ◽

10.1177/17585732211041637 ◽

2021 ◽

pp. 175857322110416

Author(s):

Olivia Lawson ◽

Jaimie A Nicholson ◽

Nicholas D Clement ◽

Will Rudge ◽

Deborah J MacDonald ◽

...

Keyword(s):

Patient Satisfaction ◽

Rotator Cuff ◽

Functional Outcome ◽

General Health ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Tear Size

Introduction There is limited medium-term outcome data regarding the predictors of functional outcome and patient satisfaction after arthroscopic rotator cuff repair. Methods 287 patients that underwent arthroscopic rotator cuff repair under a high-volume single surgeon were contacted at a minimum of 4 years following surgery. Patient demographics, tear size and co-morbidities were pre-operatively recorded. The Oxford shoulder score, EuroQol 5-dimensional score and patient satisfaction were recorded at final follow-up. Results 234 (81.5%) patients completed follow-up at a mean of 5.5 (4–9) years. There were 126 males and 108 females with a mean age of 60 (range 25–83) years. The majority of patients ( n = 211, 90%) were satisfied with their final outcome. Multivariate linear regression analysis ( R2 = 0.64) identified that increasing tear size ( p = 0.04), worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.049) were associated with a worse Oxford shoulder score. Logistic regression analysis ( R2 = 0.13) identified that worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.01) were associated with an increased risk of patient dissatisfaction. Conclusion General health status and smoking are independent predictors of functional outcome and patient satisfaction at medium-term follow-up following arthroscopic rotator cuff repair.

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Postoperative Outcomes of Single-Stage Versus Staged Bilateral Rotator Cuff Repair in Patients with Bilateral Rotator Cuff Tear: A Retrospective Study

10.21203/rs.3.rs-241612/v1 ◽

2021 ◽

Author(s):

Chen Wang ◽

Pu Yang ◽

Dongfang Zhang ◽

In-Ho Jeon ◽

Tengbo Yu ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Constant Score ◽

Single Stage ◽

Arthroscopic Rotator Cuff Repair ◽

Vas Score ◽

Ucla Score ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Abstract Background: In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair.Methods: From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. There were 24 patients in the single-stage group and 27 patients in the staged group. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, and the range of motion (ROM) of the shoulder were evaluated for comparison between the two groups before and after the operation. Moreover, the hospitalization costs in the two groups were also recorded.Results: All 51 patients were available throughout follow-up. There was no significant difference in the VAS score (P=0.424), ASES score (P=0.325), UCLA score (P=0.170), and Constant score (P=0.275) between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups. The VAS score, ASES score, UCLA score, and Constant score were significantly different between the two groups at 6 months postoperatively (P<0.05). At 12, 18, and 24 months after the operation, the VAS score, UCLA score, Constant score, and ASES score were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. Besides, there was a significant difference in hospitalization costs between the two groups (P<0.05). Furthermore, there was no significant difference in the VAS score, UCLA score, Constant score, ASES score, and ROM between the first surgery and second surgery in the single-stage group postoperatively.Conclusion: Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-up. Moreover, good outcomes were observed on both sides of the single-stage group.

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An Intra-articular Steroid Injection at 6 Weeks Postoperatively for Shoulder Stiffness After Arthroscopic Rotator Cuff Repair Does Not Affect Repair Integrity

The American Journal of Sports Medicine ◽

10.1177/0363546518777739 ◽

2018 ◽

Vol 46 (9) ◽

pp. 2192-2202 ◽

Cited By ~ 5

Author(s):

In-Bo Kim ◽

Dong Wook Jung

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Steroid Injection ◽

Arthroscopic Rotator Cuff Repair ◽

Control Group ◽

Shoulder Stiffness ◽

Shoulder Range Of Motion ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Background: Shoulder stiffness is a common complication after arthroscopic rotator cuff repair. However, there is no consensus on the treatment of stiffness after repair. Although one treatment option is an intra-articular steroid injection, it may negatively affect repair integrity, and there is a paucity of literature regarding the timing of intra-articular injections for stiffness after repair and its effect on repair integrity. Purpose: To compare repair integrity and clinical outcomes after an intra-articular steroid injection administered at 6 weeks and 12 weeks postoperatively for shoulder stiffness after arthroscopic rotator cuff repair. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who developed stiffness after arthroscopic rotator cuff repair were given a series of 3 intra-articular steroid injections every 4 weeks from 6 (6-week group) and 12 weeks (12-week group) postoperatively. The control group had rotator cuff tears but neither stiffness nor injections. Shoulder range of motion (ROM), the Korean Shoulder Scoring System (KSS) score, and the University of California, Los Angeles (UCLA) shoulder score were assessed preoperatively with a minimum of 2-year follow-up. Repair integrity was assessed using magnetic resonance imaging at 6 months postoperatively. Results: Seventy-four of 209 patients (35.4%) who underwent arthroscopic rotator cuff repair developed stiffness. There were no significant differences in retear rates among the 6-week (5.7%, 2/35 patients), 12-week (10.3%, 4/39 patients), and control groups (14.1%, 19/135 patients) ( P = .374). Both the 6- and 12-week groups showed significant improvement in ROM (both P < .001), KSS scores (both P < .001), and UCLA scores (both P < .001) at the final follow-up. The 6-week group showed significantly better ROM ( P < .001), KSS scores ( P < .001), and UCLA scores ( P < .001) than the 12-week group at 3 months postoperatively. However, both the 6- and 12-week groups showed significantly lower KSS (81.3 ± 12.0 [ P = .004] and 83.4 ± 8.6 [ P = .035], respectively) and UCLA (29.3 ± 4.6 [ P = .006] and 30.0 ± 3.3 [ P = .042], respectively) scores than the control group (90.4 ± 13.6 and 32.3 ± 4.7, respectively) at the last follow-up. Conclusion: An intra-articular steroid injection administered at 6 weeks postoperatively for shoulder stiffness after arthroscopic rotator cuff repair may be effective for reducing patients’ pain and improving shoulder ROM at 3 months postoperatively without compromising repair integrity.

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Functional outcome of arthroscopic rotator cuff repair

Orvosi Hetilap ◽

10.1556/oh.2014.29862 ◽

2014 ◽

Vol 155 (16) ◽

pp. 620-626 ◽

Cited By ~ 1

Author(s):

Imre Sallai ◽

Eszter Kővári ◽

Ádám Koteczki ◽

Balázs Kovács ◽

Péter Magyar ◽

...

Keyword(s):

Rotator Cuff ◽

Functional Outcome ◽

Rotator Cuff Repair ◽

Constant Score ◽

Postoperative Outcome ◽

Arthroscopic Rotator Cuff Repair ◽

Reconstruction Method ◽

Acromiohumeral Distance ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Introduction:Functional outcome after rotator cuff reconstruction is influenced by several factors of which re-rupture is probably the most important. Aim: The aim of the study was to evaluate the postoperative outcome including re-rupture rate after arthroscopic rotator cuff reconstruction. Method: 23 shoulders of 22 patients were examined prospectively. Physical examination, ultrasound and radiography were performed. Quality of life and functional outcome were evaluated using Constant Score and Visual Analog Scale. Results: Excellent or good results were found in 80% of the patients. The Constant Score has increased from 45 to 79, and the level of pain decreased from 6.6 to 2.5. Full-thickness rotator cuff tear was absent, but partial tear occurred in 7 cases (30%). Average acromiohumeral distance in the operated side was 8.5 mm compared to 9.5 mm measured on the contralateral shoulder. Conclusions: Arthroscopic rotator cuff repair is a safe and reliable procedure that provides good results. Orv. Hetil., 2014, 155(16), 620–626.

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