Complications associated with postoperative stiffness following rotator cuff repair

Shoulder stiffness is a common complication following rotator cuff repair (RCR) surgery. However, there is a paucity of literature on the short-term effects of postoperative stiffness on outcomes following RCR. The purpose of this study is to analyze the effect of postoperative shoulder stiffness on short-term outcomes following RCR.

The Nationwide Readmissions Database (NRD) was queried from 2015 to 2020 for primary RCR patients. Stiffness was defined using International Classification of Disease Clinical Modification and Procedure Coding System codes for arthrofibrosis, adhesive capsulitis, stiffness, synovitis, or contracture of the shoulder. Patients were separated into stiff and non-stiff cohorts and a case-control match was performed based upon age, sex, and Charlson Comorbidity Index (CCI) for a total number in the control group of 358 and a total subject count of 489. Postoperative complications, reoperations, readmissions, mortality, and hospital cost metrics were compared between cohorts using t-test and fisher's exact test.

Rates of complications, reoperation, readmission, and death were similar between the stiff and non-stiff cohorts and there were likely no clinically significant differences. Stiff patients were more likely to be discharged to home and less likely to be discharged to another type of facility (p = 0.007).

Postoperative stiffness was not predictive of increased complications, readmissions, or healthcare costs following RCR. These findings suggest that stiffness may not represent a significant clinical or economic burden, helping to guide patient expectations and management strategies. However, stiff patients were more likely to be discharged home and less likely to require facility-based care, suggesting potential differences in postoperative recovery or support needs.