Traumatic rotator cuff tears with shoulder stiffness

Abstract

Traumatic rotator cuff tears and stiffness have opposite first line treatment options. While pure traumatic rotator cuff tears may benefit from early surgical treatment followed by a short but important immobilization period, stiffness patients benefit from early and continuous mobilization and surgery is reserved for those cases that don't recover range of motion with conservative treatment. Until recently, treating patients with both conditions at the same time forced a delay in the rotator cuff repair in order to allow restoration of range of motion prior to rotator cuff surgery so that postoperative stiffness could be avoided. This surgical delay not only has been shown to negatively affect tendon repair outcomes but even with this attempt some patients never recovered full range of motion before surgery while some were noncompliant with the demanding, painful and long-lasting preoperative rehabilitation protocol. For those reasons several authors investigated the results of single-stage procedure in which patients were submitted to a capsular release, manipulation under anaesthesia and rotator cuff repair. This option has been shown to produce the same results as the staged procedure without the previously mentioned disadvantages associated with the surgical postponing, although not all patients benefit from this treatment plan.