Persistent scapular dyskinesis after arthroscopic rotator cuff repair: a prospective study

Area of Science:

• Orthopedics
• Biomechanics
• Sports Medicine

Background:

• The supraspinatus is crucial for glenohumeral joint stability and arm elevation.
• Supraspinatus tears disrupt muscle force couple balance, leading to humeral head migration and altered scapulohumeral rhythm (SHR).

Purpose of the Study:

• To prospectively compare shoulder kinematics before and after arthroscopic rotator cuff repair.
• To evaluate changes in shoulder motion and function using advanced motion analysis.

Main Methods:

• Prospective study of 21 patients undergoing arthroscopic rotator cuff repair.
• Preoperative and 12-month postoperative evaluation using ROM, Constant-Murley Score (CMS), and 3D kinematic tracking with magnetic inertial measurement units.
• SHR analysis included scapulothoracic rotations during arm elevation (flexion and abduction).

Main Results:

• Statistically significant improvements in active flexion, external rotation ROM, and CMS scores (pain, strength, total).
• No significant difference in SHR observed pre- and postoperatively, except for a minor change in tilt during flexion.
• Persistent scapular dyskinesis noted in all patients post-surgery.

Conclusions:

• Arthroscopic rotator cuff repair leads to significant functional improvements but does not fully resolve scapular dyskinesis.
• Scapular dyskinesis may impact long-term outcomes and increase re-injury risk.
• Further research is required to develop targeted rehabilitation strategies to address persistent dyskinesis and optimize patient outcomes.