RESULTS OF TREATMENT OF PATIENTS WITH PERSISTENT CONTRACTURE OF THE SHOULDER JOINT AFTER ROTATOR CUFF REPAIR

Contracture of the shoulder joint is one of the complications that ccurs after rotator cuff repair. The aim of the work is to investigate and compare the results of conservative and surgical treatment of patients with persistent contracture of the shoulder joint 6 months after shoulder rotator cuff repair. Methods. We included 51 patients who had resistant contracture of the shoulder joint of varying grade within 6 months after the operation. Conservative treatment was performed in 27 patients, surgical treatment under arthroscopic control was performed in 24 patients. In our study, we assessed the function of the shoulder using the Constant Shoulder Score and VAS scales before the start of treatment (i.e., 6 months after first surgery) 3 and 6 months after the start of treatment (i. e., 9 and 12 months after first surgery). Results. 3 months after the start of treatment, in the group where surgery was performed, the average functional result according to the Constant Shoulder Score scale was better than in the group where patients were treated conservatively and ranged within (16.4 ± 5.9) points, while in the group with conservative treatment the average functional result was (28.1 ± 6.7) points (p = 0.048). 6 months after rotator cuff repair in the group with conservative treatment the average functional result according to the Constant Shoulder Score scale was (23.1 ± 7.1) points, while in the group where surgery was performed it was (12.1 ± 6.3) points (p = 0.03). Conclusions. Performing arthroscopy with removal of scars from the s houlder joint a nd s ubacromial s pace, s elective c apsulotomy, subacromial decompression and excision of the coracoid-brachial ligament in patients with resistant contracture of the shoulder joint, which persists 6 months after the rotator cuff repair, provides better average functional results according to the Constant Shoulder Score scale and a lower level of pain syndrome according to the VAS scale in 3 and 6 months after first surgery compared to patients who continued conservative treatment.