Abstract：
Purpose: One-stage arthroscopic rotator cuff repair with manipulation has been recently performed for rotator cuff tears with shoulder stiffness, whereas some patients require capsular release due to severe stiffness that is difficult to treat with manipulation. The purpose of this study was to analyze patient backgrounds and related factors of success or failure of manipulation alone for the treatment of shoulder stiffness associated with rotator cuff tears. Methods: This study included 64 patients with rotator cuff tears and shoulder stiffness who underwent arthroscopic rotator cuff repair with manipulation alone or with manipulation and capsular release of the glenohumeral joint at our institution between January 2015 and September 2019. The patients were divided into two groups: those whose shoulder stiffness could be improved by manipulation alone (Manipulation group) and those whose stiffness could not be improved by manipulation alone and required capsular release (Capsular release addition group). Analysis was performed between the two groups regarding patient backgrounds and related factors, including rotator cuff tear morphology and range of motions pre- and postoperatively. Results: Exactly 45 patients and 19 patients were included in Manipulation group and Capsular release addition group, respectively. A comparison between the two groups showed that patient age (p = 0.0040), sex (p = 0.0005), and injury due to trauma (p = 0.0018) were significantly related to the success or failure of manipulation alone. Multivariate logistic regression analysis on these three factors showed that sex (odds ratio, 5.5; p = 0.048) was significantly associated with the success or failure of manipulation alone. In both groups, the passive ROM of all patients improved at the last postoperative follow-up compared to their pre-operative values (p < 0.001), except for internal rotation in the Capsular release addition group (p = 0.49). Conclusion: Young male patients who have shoulder stiffness associated with rotator cuff tears should be considered for arthroscopic capsular release rather than manipulation.
摘要：
目的：最近对肩袖撕裂伴肩关节僵硬进行了一期关节镜下肩袖修补术，而一些患者由于严重的僵硬而需要释放囊，这很难通过操纵来治疗。这项研究的目的是分析患者背景和单独操作治疗与肩袖撕裂相关的肩关节僵硬的成功或失败的相关因素。
方法：本研究纳入了64例肩袖撕裂和肩关节僵硬的患者，他们在2015年1月至2019年9月期间在我们机构接受了关节镜下肩袖修补术，单独操作或操作并释放盂肱骨关节囊。将患者分为两组：仅通过操纵可以改善肩关节僵硬度的患者（操纵组）和仅通过操纵不能改善僵硬度的患者，需要释放囊（增加囊释放组）。对两组患者的背景及相关因素进行分析,包括肩袖撕裂形态和手术前后的运动范围。
结果：共有45例患者和19例患者被包括在手法组和胶囊释放添加组，分别。两组之间的比较显示，患者年龄（p=0.0040），性别（p=0.0005），创伤造成的损伤（p=0.0018）与单独操作的成败显着相关。对这三个因素的多因素logistic回归分析显示，性别(优势比，5.5；p=0.048）与单独操作的成败显着相关。在这两组中,所有患者的被动ROM在最后一次术后随访时改善，与术前相比（p<0.001），除了胶囊释放添加组的内部旋转（p=0.49）。
结论：患有肩袖撕裂相关的肩关节僵硬的年轻男性患者应考虑关节镜下关节囊松解术，而不是手术。
方法：本研究纳入了64例肩袖撕裂和肩关节僵硬的患者，他们在2015年1月至2019年9月期间在我们机构接受了关节镜下肩袖修补术，单独操作或操作并释放盂肱骨关节囊。将患者分为两组：仅通过操纵可以改善肩关节僵硬度的患者（操纵组）和仅通过操纵不能改善僵硬度的患者，需要释放囊（增加囊释放组）。对两组患者的背景及相关因素进行分析,包括肩袖撕裂形态和手术前后的运动范围。
结果：共有45例患者和19例患者被包括在手法组和胶囊释放添加组，分别。两组之间的比较显示，患者年龄（p=0.0040），性别（p=0.0005），创伤造成的损伤（p=0.0018）与单独操作的成败显着相关。对这三个因素的多因素logistic回归分析显示，性别(优势比，5.5；p=0.048）与单独操作的成败显着相关。在这两组中,所有患者的被动ROM在最后一次术后随访时改善，与术前相比（p<0.001），除了胶囊释放添加组的内部旋转（p=0.49）。
结论：患有肩袖撕裂相关的肩关节僵硬的年轻男性患者应考虑关节镜下关节囊松解术，而不是手术。
