The effect of preemptive middle glenohumeral ligament release, following release of the rotator interval and coracohumeral ligament, in arthroscopic rotator cuff repair of small- to medium-sized tears to prevent postoperative stiffness: a retrospective comparative study

Abstract

Background: This study aimed to evaluate the efficacy of pre-emptive middle glenohumeral ligament (MGHL) release during arthroscopic rotator cuff repair (ARCR) of small- to medium-sized tears to prevent postoperative stiffness. Methods: Patients who underwent ARCR of small- to medium-sized tears were enrolled and allocated into 2 groups retrospectively: the pre-emptive MGHL release group (MGHL+ group, n = 34) and pre-emptive MGHL nonrelease group (MGHL− group, n = 32). The rotator interval and coracohumeral ligament release were performed in all patients with or without MGHL release in both groups. Clinical outcomes including the range of motion; Constant Shoulder score; and the University of California, Los Angeles score preoperatively and at 3 months, 6 months, and 12 months postoperatively and complications were assessed and compared between the 2 groups. The integrity of the repaired tendon was assessed at the 12-month follow-up using magnetic resonance imaging. Results: The MGHL+ group showed a significantly higher external rotation; Constant Shoulder score; and the University of California, Los Angeles score than the MGHL− group at 6 months postoperatively (P = .03, .05). The retear rate, postoperative stiffness, and postoperative instability were not significantly different between the groups (all, P > .05). Conclusion: Pre-emptive MGHL release in ARCR of small- to medium-sized tears could be an effective method to prevent early postoperative shoulder stiffness but does not significantly change the overall clinical outcome after ARCR.

Keywords

• Middle glenohumeral ligament
• Pre-emptive middle glenohumeral ligament release
• Postoperative stiffness
• Arthroscopic rotator cuff repair
• Shoulder stiffness
• Shoulder pain