Tuesday, March 31, 2015

No need to delay rotator cuff surgery, study finds

UNSW research has found waiting months for a stiff shoulder to settle down before surgery may not be necessary, offering thousands of people with painful rotator cuff injuries hope of a speedier recovery. 
The world-first research found patients who underwent traditional surgery as well as a procedure to relieve stiffness, enjoyed the same improvements and less re-tearing two years later, compared to a control group who only received rotator cuff surgery.

The rotator cuff is a group of muscles and tendons that surround the shoulder, keeping the head of your upper arm bone firmly. A rotator cuff injury that occur most often in people who repeatedly perform overhead motions in their jobs or sportscan, and increase with age, cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.

The procedure, known as a glenohumeral joint capsule release, involves arthroscopically manipulating a patient’s shoulder under anaesthesia at the time of surgery.
UNSW student researcher and lead author of the study, Jordan McGrath, based at St George Hospital, said results from 25 patients who were given the simultaneous shoulder manipulation were compared with 170 patients who received only rotator cuff surgery.
McGrath said both groups reported significant improvements in range of motion, pain, and function after surgery.
“However, patients who received both procedures also saw no re-tear of the shoulder two years following the operation, compared to only 20% of those who received only a rotator cuff repair,” he said.
UNSW Professor George Murrell, Director of the Orthopaedic Research Institute at St George Hospital, said currently doctors are inclined to postpone surgery on patients with shoulder stiffness.
“Our research suggests that may not be the best treatment approach.
“We hope these findings make a positive impact and reduce the recovery period, particularly for the many older Australians who suffer rotator cuff injuries,” Professor Murrell said.
Rotator cuff tears increase with age with more than half of people aged over 50 suffering the injury in their lifetime.
The UNSW study was presented today in Las Vegas at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day.