The Incidence of Postoperative Shoulder Stiffness After Arthroscopic Rotator Cuff Repair: A Systematic Review

Rotator cuff tear (RCT) is a common shoulder condition frequently treated with arthroscopic rotator cuff repair (ARCR) after conservative interventions have failed. Postoperative shoulder stiffness (POSS) is a common complication after ARCR. The purpose of this study is to determine the incidence of POSS after ARCR in total and based on tear extent prior to ARCR. A systematic review was performed using PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), and ScienceDirect databases. The search terms were "rotator cuff repair" AND "arthrofibrosis" OR "postoperative shoulder stiffness." Articles were selected based on ARCR and the presence of POSS documentation. Twenty-five articles out of 284 articles met the final selection criteria after reviewing for patients who received ARCR. Out of all patients (n=9,373), 597 had POSS (6.4%). Out of the 2,424 patients with a specified tear pattern, 96 out of 1,862 (5.2%) patients with full-thickness tears and 58 out of 562 (10.3%) patients with partial-thickness tears had POSS after ARCR. Partial-thickness tears are associated with higher rates of POSS after ARCR as compared to full-thickness tears (p<0.001). Overall, POSS is a common complication after ARCR with an incidence of 6.4%, regardless of tear type. POSS is more common in patients who receive ARCR for partial-thickness RCT (10.3%) as compared to patients who receive ARCR for full-thickness RCT (5.2%). More research is needed to determine other factors impacting the incidence of POSS after ARCR.