Smoking, Diabetes, Workers' Compensation, and Traumatic Tears Are Risk Factors for Postoperative Shoulder Stiffness...

To analyze demographic, anatomic, intraoperative, and preoperative patient reported outcomes surveys associated with post arthroscopic rotator cuff repair (RCR) shoulder stiffness, as defined by patients requiring an arthroscopic release.

Patients from 2005 to 2021 with at least 1 year of follow-up who retrospectively met the inclusion criteria of undergoing an arthroscopic RCR followed by arthroscopic release were matched by age, sex, body mass index, and concomitant procedures to a database of RCR patients without arthroscopic release. Univariate and stepwise multivariate logistic regressions were performed to determine variables associated with post-operative stiffness.

A group of 75 stiff patients met the inclusion criteria and were matched to 75 patients without stiffness. The stiffness group had a higher prevalence of smoking (21% vs 5%; P = .012), diabetes (31% vs 8%; P = .003), workers' compensation (63% vs 27%; P < .001), traumatic tears (64% vs 34%; P < .001), and non-English speaking patients (12% vs 3%; P = .045). There were fewer white patients in the stiff cohort (38% vs 71%; P < .001). Preoperative forward flexion (133.5° ± 32.2° vs 148.4° ± 33.4°; P = .012), Single Assessment Numeric Evaluation (25.8 ± 18.8 vs 44.1 ± 26.4; P = .002), American Shoulder and Elbow (33.9 ± 20.6 vs 49.3 ± 22.0; P = .005), and VR-12 Physical scores (36.1 ± 7.7 vs 40.8 ± 8.2; P = .006) were lower in stiff patients.

Smoking status, diabetes, workers' compensation status, and traumatic tears were all significantly more prevalent in patients who required postoperative arthroscopic release with manipulation under anesthesia. Preoperative forward flexion and patient reported outcomes were also decreased in this cohort suggesting that patients presenting with these deficiencies are at higher risk for developing a stiff shoulder after RCR.

Level III, comparative case series.