Surgical results in rotator cuff tears with shoulder stiffness

Background/Purpose: Little has been mentioned about the treatment of rotator cuff tears and associated shoulder stiffness. We prospectively treated a series of patients with rotator cuff tears associated with shoulder stiffness concomitantly and reported the outcomes. Methods: A combined procedure of manipulation, lysis of adhesions, anterior acromioplasty and repair of rotator cuff was performed on 43 patients (47 shoulders) who were available for follow-up for a minimum of 2 years. Ten patients (11 shoulders) had diabetes mellitus and 33 patients (36 shoulders) were non-diabetic. Partial tear of the rotator cuff was noted in 27 shoulders, complete tears in 15 shoulders and massive tears in five shoulders. A functional score of Constant and Murley was used to evaluate the overall outcomes, the results between patients with and without diabetes mellitus and the results among different types of rotator cuff tears. Results: At a mean ( SD) of 48.61 +/- 18.0 months (range, 24-85 months) after the operation, each patient showed a significant improvement in subjective score, objective score and strength score as well as in the total score of Constant and Murley. There was no statistical difference in postoperative total Constant scores between patients with and without diabetes mellitus (p = 0. 123). Comparison of the scores among the three types of rotator cuff tears revealed that all had a significant improvement in the total scores of Constant and Murley (44.6 + 7.7 vs. 91.7 4.9, p < 0.001 for a partial cuff tear; 42.9 11.3 vs. 86.0 9.6, p = 0.001 for a complete tear; and 44.2 +/- 4.8 vs. 82.0 +/- 12. 1, p = 0.043 for a large tear), but patients with partial tears of the rotator cuff had significantly better total scores than did those with complete tears (92.6 +/- 4.8 vs. 82.0 +/- 12. 1, p = 0.018) or large tears (92.6 +/- 4.8 vs. 86.1 +/- 9.7, p = 0.041). Conclusion: A combined procedure of manipulation, lysis of adhesions, acromioplasty and repair of rotator cuff is a satisfactory procedure for patients with rotator cuff tears and associated shoulder stiffness.