Evidence map›Paper›PMID 41376438›Full record

ArticleClinics in shoulder and elbow2025

Arthroscopic rotator cuff repair with manipulation under anesthesia yields similar clinical outcomes to isolated rotator cuff repair and is associated with lower retear rates in medium-sized tears.

Yutaka Kinoshita, Yoshitsugu Takeda, Koji Fujii, Naoto Suzue, Yoshiteru Kawasaki, Junichiro Sumitomo, Kenichiro Kita, Yugen Fujii, Koichi Sairyo

Abstract read
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Article in Clinics in shoulder and elbow, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yutaka KinoshitaDepartment of Orthopedics, Institute of Health Bioscience, University of Tokushima Graduate School, Tokushima, Japan.
Yoshitsugu TakedaDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Koji FujiiDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Naoto SuzueDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Yoshiteru KawasakiDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Junichiro SumitomoDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Kenichiro KitaDepartment of Orthopedic Surgery, Tokushima Red Cross Hospital, Tokushima, Japan.
Yugen FujiiDepartment of Orthopedics, Institute of Health Bioscience, University of Tokushima Graduate School, Tokushima, Japan.
Koichi SairyoDepartment of Orthopedics, Institute of Health Bioscience, University of Tokushima Graduate School, Tokushima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of manipulation under anesthesia (MUA) without arthroscopic capsular release in patients with preoperative stiffness undergoing arthroscopic rotator cuff repair (ARCR) remains unclear. Additionally, the association between shoulder stiffness and tendon healing after ARCR is still controversial. This study aimed to compare the clinical outcomes and retear rates between patients with preoperative stiffness treated by MUA alone and those without stiffness.

methodsThis retrospective study included 322 patients who underwent ARCR for full-thickness tears between January 2012 and May 2022 with a minimum 2 years of follow-up. Clinical outcomes-including passive range of motion (ROM); the Japanese Orthopedic Association (JOA) score; and the University of California, Los Angeles (UCLA) score-were assessed preoperatively and at 3, 6, 12, and 24 months postoperatively. Patients were divided into the stiffness group (MUA completed) and the non-stiffness group. Retears were evaluated using magnetic resonance imaging at 6 months postoperatively, and retear rates were analyzed by tear size (medium vs. large/massive).

resultsEighty-eight patients with stiffness and 234 without stiffness met the study inclusion criteria. Preoperative ROM, JOA, and UCLA scores were significantly lower in the stiffness group. Both groups showed significant improvements at final follow-up, with greater gains in the stiffness group. Final outcomes were comparable, except for external rotation. In medium-sized tears, the retear rate was significantly lower in the stiffness group (1.9%) than in the non-stiffness group (10.8%) (P=0.042). No significant difference was observed for large/massive tears.

conclusionsPatients with preoperative stiffness treated with MUA alone achieved comparable outcomes to those without stiffness, with improved tendon healing in medium-sized tears. Level of evidence: III.

Indexed as

ArthroscopyJoint stiffnessManipulationRotator cuff injuriesShoulder

Identifiers

PMID41376438
PMCPMC12698357

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