SHOULDER STIFFNESS AFTER ARTHROSCOPIC SURGERY

Authors: PL Chaumont; R Charvet; T George; D Bellan; JP Delagoutte;H Coudane

References: Presented at SECEC 2009

Purpose
We have prospectively followed the shoulder arthroscopies that originated in our department in 2007. The purpose of this study was to record postoperative shoulder stiffness in order to find favorable factors.

Material and Methods
98 arthroscopies were performed in 2007 among 97 patients. These arthroscopies were realized to treat rotator cuff ruptures (60), calcific tendinopathies (10), subacromial impingement syndromes (18), and instabilities (12). 37 females and 60 males, mean age 53.6 years, were treated. The occupation, the number of accidents at work or occupational diseases, the passive mobility were noted before surgery. The passive articular mobility and the Constant score were noted during the follow-up care. In case of stiffnesses, the time they took to appear and the duration of their development were noted. The tests we carried out did not meet specific parameters but they were chosen according to the population.

Results
We recorded 16 different stiffness levels. The average time they took to appear was 56 days postoperatively and the average duration of their development was 5 months. There was no connection between the appearance of postoperative stiffness and the sex, the age, or the previous history of the patient. The arthroscopic surgery after impingement syndrome or calcification excision is significantly at higher risk of stiffness than the cuff surgery.

Conclusion
The significant difference between conflict surgery and cuff repair surgery may have a link with the immobilizations and/or with the postoperative reeducation protocols. The difference of the stiffness rate observed between repairing surgery and conflict surgery should lead us to reconsider the rehabilitation protocols.