Captured shoulder: a complication of rotator cuff surgery

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Subdeltoid adhesions can develop after rotator cuff repair, leading to persistent pain and restricted motion.
• These adhesions may be associated with chondral lesions on the humeral head.
• Patients experiencing dissatisfaction post-rotator cuff repair require further investigation.

Purpose of the Study:

• To identify and characterize patients with restrictive subdeltoid adhesions post-rotator cuff repair.
• To evaluate the efficacy of arthroscopic takedown of these adhesions.
• To propose a theory explaining the development of these adhesions.

Main Methods:

• Retrospective review of thirteen patients who underwent second-look arthroscopy for subdeltoid adhesions.
• Takedown of adhesions performed at an average of 37 weeks post-index surgery.
• Clinical and functional outcomes assessed using University of California, Los Angeles (UCLA) scores and range of motion measurements pre- and post-release.

Main Results:

• Arthroscopic findings included subdeltoid adhesions and companion chondral lesions of the humeral head.
• Post-release, average UCLA scores improved from 14.8 to 30.1, and pain scores improved from 2.6 to 7.7.
• Significant improvements were noted in flexion, abduction, internal rotation, and external rotation post-adhesion release.

Conclusions:

• Restrictive subdeltoid adhesions are a distinct complication following rotator cuff repair.
• Arthroscopic release of subdeltoid adhesions is an effective treatment for improving shoulder function and pain.
• Understanding the etiology of these adhesions may help prevent their occurrence.