Abstract:

Objective

To compare and analyze the effects of arthroscopic rotator cuff repair release and arthroscopic rotator cuff repair manual release in the treatment of rotator cuff tear complicated with adhesive shoulder capsitis.

Methods

A total of 96 patients with rotator cuff tear combined with adhesive shoulder capsitis were selectedin Jianhu County People's Hospital from October 2019 to October 2022. The inclusion criteria were as follows： there was no significant effect after conservative treatment， and the patients were eligible for rotator cuff tear combined with adhesive shoulder capsitis and underwent preoperative MRI examination of shoulder joint. Exclusion criteria： patients with shoulder infection； large rotator cuff tear，irreparable rotator cuff tear； serious shoulder problems and so on. A random number table was used to divide the subjects into two groups： 48 cases in the arthroscopic rotator cuff repair shoulder joint release group（the intraoperative release group） and 48 cases in the arthroscopic rotator cuff repair manual release group（the manual release group）. Visual analogue scale（VAS）， University of California at Los Angeles shoulder score（UCLA ） and shoulder motion were compared before surgery， one， three and sixmonths after surgery in the two groups. Independent sample t test was used for comparison between the two groups， chi square test was used for classification data such as gender composition ratio， and repeated measurement ANOVA was used for changes in VAS， UCLA scores and shoulder joint motion at multiple time points in the two groups.

Results

There was no statistically significant difference in range of motion， UCLA and VAS scores between the two groups before surgery （ all P＞0.05）. At one， three and six months after surgery， the intraoperative release group had better mobility than the manual release group， and the difference was statistically significant（abduction： t=4.660， 11.145， 8.667， all P ＜0.05； forward flexion： t=3.830， 7.574， 6.890， all P＜0.05；lateral external torsion： t=4.068， 2.034， 2.979， all P＜0.05； extension and internal rotation： t=2.254， 5.543，5.433， all P＜0.05）. The UCLA scores of the intraoperative release group were better than those of the manual release group， and the difference was statistically significant （t=3.336， 7.598， 8.777， all P＜0.05）. The VAS scores of the intraoperative release group were better than those of the manual release group， and the difference was statistically significant （t=18.304， 18.480， 23.741， all P＜0.05）.

Conclusions

Arthroscopic rotator cuff repair and shoulder joint release in the treatment of rotator cuff tear complicated with adhesive shoulder capsitis can significantly reduce pain and improve shoulder joint function. Compared with the rotator cuff repair technique under the microscope， the manual release effect is better and the recovery of patients is better， which is worthy of application and promotion.

Key words: Arthroscope, Shoulder joint, Rotator cuff, Rotator cuff injuries, Bursitis