Captured shoulder: a complication of rotator cuff surgery

Thirteen patients who developed restrictive subdeltoid adhesions after rotator cuff repair were identified. These patients underwent second-look arthroscopy and takedown of adhesions at an average of 37 weeks after their index surgery. Clinical findings include pain and restricted motion that does not yield to manipulation under anesthesia. Arthroscopic findings are subdeltoid adhesions and a chondral lesion (companion lesion) of the humeral head articular surface. Patients were reevaluated at 26 weeks after their release of adhesions. Prerelease and postrelease University of California, Los Angeles (UCLA) scores average 14.8 and 30.1, respectively. Prerelease and postrelease UCLA pain scores averaged 2.6 and 7.7, respectively. Prerelease and postrelease range of motion was as follows: Flexion, 141/158; abduction, 123/141; internal rotation, 47/69; and external rotation, 53/74. The authors have proposed a theory to explain the clinical and arthroscopic findings in this subgroup of patients who are dissatisfied after rotator cuff repair. A technique for and the results of release of the subdeltoid adhesions also are reported.