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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 12, pp 3881–3889 | Cite as

The effect of concomitant coracohumeral ligament release in arthroscopic rotator cuff repair to prevent postoperative stiffness: a retrospective comparative study

  • Joo Hyun Park
  • Seok Hoon Yang
  • Sung Min Rhee
  • Joo Han OhEmail author
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Abstract

Purpose

This study was to evaluate the efficacy and safety of coracohumeral ligament (CHL) release from the coracoid process concomitant with arthroscopic rotator cuff repair for preventing postoperative stiffness.

Methods

Data on patients who underwent arthroscopic rotator cuff repair with a minimum follow-up of 1 year were collected retrospectively. Propensity score matching (1-to-1) was performed between a no-releasing group (Group I) and CHL-releasing group (Group II). In total, 76 patients in each group were matched. Clinical outcomes were assessed and compared between the two groups, including range of motion (ROM) and visual analogue scale for pain (pVAS) at postoperative 3 months, 6 months, and 1 year. The integrity of the repaired tendon was assessed at 1-year follow-up using either magnetic resonance imaging or ultrasonography.

Results

External rotation (ER) at side at postoperative 3 months in Group II was better than that in Group I (48.6° ± 11.6° vs. 38.4° ± 13.0°, P < 0.001). When evaluating only patients with a small-to-medium sized tear at postoperative 3 months, ER at side was 49.8° ± 10.9° in Group II versus 37.8° ± 13.1° in Group I (P < 0.001). In patients with a large-to-massive sized tear, however, there was no significant difference in ER at side at postoperative 3 months (n.s.). There was no significant difference in ROM and functional scores at postoperative 6 months and 1 year, and there was no significant difference in healing failure rate (6 cases in Group I (7.9%), 2 cases in Group II (2.6%); n.s.). No complications of the CHL release procedure occurred.

Conclusions

In arthroscopic rotator cuff repair, CHL release from the coracoid process without creating a rotator interval defect could be an effective and safe method to prevent early postoperative stiffness, especially ER at side in patients with a small-to-medium sized tear. Therefore, CHL release can be used as a selective procedure to prevent postoperative stiffness in patients that may benefit from this procedure with decreased preoperative ER compared to the normal side.

Level of evidence

Level III.

Keywords

Rotator cuff tear Rotator cuff repair Coracohumeral ligament Coracoid process Range of motion 
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Notes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Institutional Review Board approved an exemption for this study due to its retrospective design (IRB No.: B-1808/484-106, Seoul National University Bundang Hospital Institutional Review Board).

Informed consent

For this type of study, formal informed consent was not required.

Supplementary material

Supplementary material 1 (MOV 6939 KB)

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgerySeoul National University College of Medicine, Seoul National University Bundang HospitalSeongnam-siRepublic of Korea
  2. 2.KS HospitalSeoulRepublic of Korea

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