Postoperative stiffness and rotator cuff tendon healing: a narrative review

Range of motion restriction or shoulder stiffness is common in rotator cuff tear patients. Shoulder stiffness occurs both preoperatively and postoperatively and contributes to patient dissatisfaction. However, recent studies have suggested that shoulder stiffness may be associated with a greater healing response and lower retear rate. Elevated levels of cytokines such as interleukin (IL)-6, IL-1β, and IL-8 in the joint fluid, synovial tissue, and subacromial bursa of patients with shoulder stiffness suggests an increased healing response following tendon injury. Understanding the mechanisms underlying tendon healing and the development of shoulder stiffness may aid in the development of novel therapies to improve outcomes following rotator cuff surgery.