Complications following Arthroscopic Rotator Cuff Repair
Authors: Kenneth Brislin, MD Allentown PA
References: AAOS 2005
Twenty-eight patients from a consecutive group of 263 undergoing arthroscopic rotator cuff repair developed postoperative complications (10.6%), and the great majority were related to stiffness.
Arthroscopic rotator cuff repair has become much more commonly performed, and the short term and mid term results following arthroscopic repair have proved comparable to open repair in several studies. However, there has been a paucity of literature regarding the complications associated with arthroscopic repair. The purpose of this study was to determine the complication rate for a consecutive group of patients undergoing arthroscopic rotator cuff repair.
A retrospective chart review of 263 consecutive patients undergoing arthroscopic rotator cuff repair between January, 2003 and June, 2003 was carried out. Twenty-eight patients (10.6 %) developed a postoperative complication. There were no intraoperative complications.
The average age of the patients with complications was 61 years (26-76 years), and there were 10 men and 18 women in this group. Of the 28 patients, 23 were diagnosed with significant stiffness. Stiffness was considered a complication only when it persisted for 3 months or more following surgery and was defined as less than 100 degrees of passive forward flexion, less than 10 degrees of passive external rotation, and/or less than 30 degrees of external rotation at 90 degrees abduction. Other complications included deep vein thrombosis (1), reflex sympathetic dystrophy (1), persistent pain (1), infection (1), and death (1). The postoperative stiffness resolved adequately in all but one patient at an average of 4.7 months. This patient subsequently underwent an arthroscopic capsular release at 4 months postoperatively.
This study demonstrated an overall complication rate of 10.6 percent following arthroscopic rotator cuff repair and represents the only identified study assessing complications specifically following arthroscopic rotator cuff repair. Persistent postoperative stiffness was the most common complication and emphasizes the fact that an all arthroscopic approach does not statistically significantly reduce its occurrence compared to open rotator cuff repair studies. However, the overall complication rate compares favorably to studies assessing outcomes after open or mini-open repair.