Purpose
To study the effects on pain as the main outcome parameter and on function and cuff
integrity as the secondary outcome parameters after arthroscopic rotator cuff repair
in the short term comparing the abduction brace with an antirotation sling for postoperative
shoulder immobilization.
Methods
Eligible patients were between the ages of 18 and 75 years who were diagnosed with
a traumatic or degenerative tear of the supraspinatus and/or infraspinatus tendon,
confirmed by magnetic resonance imaging, for which an arthroscopic footprint repair
was indicated and performed. Patients were randomly allocated to the antirotation
sling or abduction brace group. Postoperative pain and use of analgesics were accurately
registered up to 3 months after surgery using a patient diary. Follow-up examinations
including the Constant-Murley score, Western Ontario Rotator Cuff index, and glenohumeral
range of motion were scheduled 6 weeks, 3 and 6 months, and 1 year after surgery.
Results
The average level of pain measured directly postoperation up to 1 year after surgery
was not significant different between groups. Postoperatively, function scores and
glenohumeral range of motion improved significantly for both groups; however, no differences
were observed between groups. No retears were observed on ultrasonograph 3 months
after surgery.
Conclusions
In the short term, the level of pain, function, and quality of life were not significantly
different between the use of an abduction brace and that of an antirotation sling
after arthroscopic rotator cuff repair. Based on these findings, the abduction brace
used in this study does not seem to be the solution for decreasing the pain experienced
in the first postoperative weeks after arthroscopic rotator cuff repair, and both
are recommendable.
Level of Evidence
Level I, randomized controlled trial.
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References
- Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears.J Bone Joint Surg Am. 2007; 89: 747-757
- Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique—Margin convergence versus direct tendon-to-bone repair.Arthroscopy. 2001; 17: 905-912
- Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up.Arthroscopy. 2002; 18: 136-144
- Arthroscopic rotator cuff repair: 4- to 10-year results.Arthroscopy. 2004; 20: 5-12
- Arthroscopic rotator cuff repair: Suture anchor properties, modes of failure and technical considerations.Expert Rev Med Devices. 2011; 8: 377-387
- Can gabapentin help reduce postoperative pain in arthroscopic rotator cuff repair? A prospective, randomized, double-blind study.Arthroscopy. 2010; 26: S106-S111
- Continuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: The effects on postoperative analgesia and motor function.Anesth Analg. 2010; 111: 1543-1547
- Assessment of pain relief provided by interscalene regional block and infusion pump after arthroscopic shoulder surgery.Arthroscopy. 2008; 24: 14-19
- Efficacy of subacromial ropivacaine infusion for rotator cuff surgery. A randomized trial.J Bone Joint Surg Am. 2009; 91: 1558-1567
- A new nerve block procedure for the suprascapular nerve based on a cadaveric study.J Shoulder Elbow Surg. 2009; 18: 607-611
- Pain after shoulder arthroscopy: A prospective study on 231 cases.Orthop Traumatol Surg Res. 2011; 97: 260-266
- Rotator cuff repair tension as a determinant of functional outcome.J Shoulder Elbow Surg. 2000; 9: 502-506
- The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears.J Bone Joint Surg Am. 2004; 86: 219-224
- Estimating optimal shoulder immobilization postures following surgical repair of massive rotator cuff tears.J Biomech. 2013; 46: 179-182
- Stress on the rotator cuff sutures in relation to joint position.Z Orthop Ihre Grenzgeb. 1993; 131: 317-322
- Passive tension and gap formation of rotator cuff repairs.J Shoulder Elbow Surg. 2004; 13: 664-667
- Postural dependence of passive tension in the supraspinatus following rotator cuff repair: A simulation analysis.Clin Biomech (Bristol, Avon). 2011; 26: 804-810
- Does a brace influence clinical outcomes after arthroscopic rotator cuff repair?.Musculoskelet Surg. 2015; 99: S31-S35
- Multimodal analgesia for arthroscopic rotator cuff repair: A randomized, placebo-controlled, double-blind trial.Eur J Orthop Surg Traumatol. 2014; 24: 315-322
- Administration of analgesics after rotator cuff repair: A prospective clinical trial comparing glenohumeral, subacromial, and a combination of glenohumeral and subacromial injections.J Shoulder Elbow Surg. 2015; 24: 663-668
- Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting.Reg Anesth Pain Med. 2008; 33: 122-128
- Classification of rotator cuff lesions.Clin Orthop Relat Res. 1990; 254: 81-86
- Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology.Acta Orthop Scand. 1996; 67: 264-268
- Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan.Clin Orthop Relat Res. 1994; 304: 78-83
- A radiographic classification of massive rotator cuff tear arthritis.Clin Orthop Relat Res. 2011; 469: 2452-2460
- Roentgenographic assessment of acromial morphology using supraspinatus outlet radiographs.Arthroscopy. 2001; 17: 496-501
- The conceptually equivalent Dutch version of the Western Ontario Rotator Cuff Index (WORC)©.BMC Musculoskelet Disord. 2013; 14: 362
- Long-term results of surgical repair of full-thickness rotator cuff tears.in: Bateman J.E. Welsh R. Surgery of the shoulder. CV Mosby, Philadelphia, PA1984: 167-171
- When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears.Am J Sports Med. 2011; 39: 2064-2070
- Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease.J Shoulder Elbow Surg. 2009; 18: 927-932
- Determination of moderate-to-severe postoperative pain on the numeric rating scale: A cut-off point analysis applying four different methods.Br J Anaesth. 2011; 107: 619-626
- Continuous interscalene brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study.Anesth Analg. 2003; 96: 1089-1095
- Analgesic effects of low-dose ropivacaine for interscalene brachial plexus block for outpatient shoulder surgery—A dose-finding study.Reg Anesth Pain Med. 2001; 26: 439-443
Article info
Publication history
Published online: April 17, 2017
Accepted:
February 10,
2017
Received:
June 7,
2016
Footnotes
See commentary on page 1627
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2017 by the Arthroscopy Association of North America