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Types and doses of anti-adhesive agents injected into subacromial space do not have an effect on the clinical and anatomical outcomes after arthroscopic rotator cuff repair

  • SHOULDER
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Joint stiffness after arthroscopic rotator cuff repair is a major concern for orthopaedic surgeons. Various antiadhesive agents are commonly administered after rotator cuff repair for its prevention. This study aimed to compare the outcomes among patients injected with different types and amounts of anti-adhesive agents after rotator cuff repair. It was hypothesized that the outcomes might differ depending on the use of the anti-adhesive agent and its type and dose.

Methods

A total of 267 patients who underwent arthroscopic rotator cuff repair with or without subacromial injection of anti-adhesive agents were enrolled. The first group (group A; 51 patients) were injected with 3 mL of poloxamer/sodium alginate-based anti-adhesive agent. The second group (group B; 93 patients) were injected with 3 mL of sodium hyaluronate-based anti-adhesive agent. The third group (group C; 82 patients) were injected with 1.5 mL of sodium hyaluronate-based anti-adhesive agent. Finally, the last group (group D; 41 patients) who did not use anti-adhesive agents served as the control. The range of motion (ROM) and pain VAS scores were measured preoperatively and at 5 weeks, 3 months, 6 months, and 1 year postoperatively. Functional outcomes were evaluated using American Shoulder and Elbow Surgeons and Constant scores, whereas cuff integrity was assessed via MRI or ultrasonography at least 6 months postoperatively.

Results

All ROM measurements, pain VAS scores, and functional scores were significantly improved regardless of the use, type, and dose of the anti-adhesive agents. In addition shoulder ROM and rotator cuff healing did not significantly differ among the groups (all n.s.).

Conclusions

No significant differences were found in the clinical and anatomical outcomes according to the type and dose of the anti-adhesive agents subacromially injected after rotator cuff repair.

Level of evidence

III.

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Data availability

Individual data used in this study cannot be provided to protect patient privacy.

Abbreviations

ROM:

Range of motion

VAS:

Visual analogue scale

ASES:

American Shoulder and Elbow Surgeons

MRI:

Magnetic resonance imaging

ER:

External rotation

IR:

Internal rotation

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Acknowledgements

This work was supported by the Konkuk University Medical Center Research Grant 2022. The authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

Funding

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. RS 2023 00249219).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Center for Shoulder and Elbow Surgery, Konkuk University School of Medicine, 120-1 Neungdong-Ro (Hwayang-Dong), Gwangjin-Gu, Seoul, 143-729, Korea

    Jongwon Lee, Youngje Woo, Kyung-Soo Oh & Seok Won Chung

  2. Department of Orthopaedic Surgery, Kyungpook National University, School of Medicine, Daegu, South Korea

    Jong Pil Yoon

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  1. Jongwon Lee
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Correspondence to Seok Won Chung.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of the Konkuk University (No. KUMC 2022-02-022).

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Lee, J., Yoon, J.P., Woo, Y. et al. Types and doses of anti-adhesive agents injected into subacromial space do not have an effect on the clinical and anatomical outcomes after arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 31, 5238–5247 (2023). https://doi.org/10.1007/s00167-023-07519-4

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