Patient-reported outcome measures (PROMs) are routinely used to assess pain, function, and quality of life in shoulder care. Although rotator cuff repair (RCR) is a highly effective treatment for symptomatic tears, the relationship between structural healing and PROM responsiveness remains unclear. This study aimed to evaluate and compare the responsiveness of 5 common shoulder PROMs-the Penn Shoulder Score, modified American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Shoulder Activity Level (SAL), and Patient-Reported Outcome Measure Information System Upper Extremity-as well as individual items from these measures and the Western Ontario Rotator Cuff Index, to RCR surgery and healing at 1 year postoperatively, with secondary analyses at 6 months and 2 years. A prospective cohort of 117 patients undergoing arthroscopic RCR for fully reparable 1-5 cm supraspinatus/infraspinatus tears was analyzed. PROMs were collected preoperatively and at 6 months, 1 year, and 2 years postoperatively. RCR healing was assessed using magnetic resonance imaging-based Sugaya classification and computed tomography-measured tendon retraction. Responsiveness was evaluated using standardized response means, with subgroup analyses comparing healed and nonhealed patients. Correlations between PROMs and structural healing were analyzed. All PROMs and their individual items (except SAL) demonstrated high responsiveness to RCR surgery (standardized response mean >0.8) during the first 2 postoperative years, regardless of structural healing status, with the majority of gains occurring within the first 6 months. However, neither total PROMs nor select high-function items demonstrated correlations with structural healing (r < 0.3), indicating PROMs improvements primarily reflected reduced pain and enhanced daily function rather than RCR integrity. At 1 year, 92% of patients reported an acceptable symptom state (Patient Acceptable Symptom State "yes"), including all patients meeting stringent criteria for failed RCR. SAL was unresponsive to RCR surgery in the overall cohort and demonstrated limited utility in assessing functional differences in this patient population. Penn Shoulder Score, American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Patient-Reported Outcome Measure Information System Upper Extremity demonstrated progressively increasing ceiling effects postoperatively. Shoulder PROMs are highly responsive to RCR surgery but even their highest function items lack sensitivity to structural healing during the first 2 postoperative years. PROM improvements primarily reflect subjective gains in pain relief and daily function, highlighting the need for alternate outcome measures incorporating objective functional assessments to better define the impact of RCR healing in the early term. Future research should focus on developing PROMs with lesser ceiling effects postoperatively and evaluating the longer-term clinical consequences of failed structural RCR healing.

Arthroscopic rotator cuff repair (ARCR) generally improves clinical outcomes, but the impact of pre-existing glenohumeral osteoarthritis (GHOA) severity on these outcomes remains unclear. This study aims to evaluate the correlation between preoperative GHOA severity, assessed via the Shoulder Osteoarthritis Severity (SOAS) score, and postoperative patient-reported outcomes (PROs) following ARCR with a minimum of two years follow-up. In this retrospective cohort study, 150 patients who underwent ARCR between 2018 and 2023 were included. Preoperative GHOA severity was assessed independently by two reviewers using magnetic resonance imaging (MRI) and graded using the SOAS score. PROs included the American Shoulder and Elbow Surgeons (ASES) score, University of California-Los Angeles (UCLA) score, and Western Ontario Rotator Cuff (WORC) index. Correlation and multivariate regression analyses were used to identify predictors of PROs. Receiver operating characteristic (ROC) curve was performed to assess the SOAS score's predictive value. Of 150 eligible patients, the cohort had a mean age of 66.6 ± 8.8 years and a mean follow-up of 42.3 ± 14.5 months. Inter-reader reliability of total SOAS was excellent (ICC = 0.942). Higher total SOAS scores were significantly associated with lower ASES (r=-0.21, p = 0.012) and UCLA (r=-0.22, p = 0.006) scores. Subdomain analysis revealed that labral-bicipital complex pathology negatively correlated with all three PROs (ASES: r=-0.21, p = 0.010; UCLA: r=-0.20, p = 0.013; WORC: r=-0.18, p = 0.026), while cartilage degeneration correlated with lower UCLA score (r=-0.18, p = 0.033). On multivariate analysis, long head of biceps pathology was an independent predictor of a lower ASES score (β=-2.14, p = 0.029) and WORC index (β=-0.1, p = 0.032). An optimal SOAS cut-point of 17 for predicting failure showed poor discriminative ability (AUC = 0.596). The SOAS score demonstrated a significant correlation with Kellgren-Lawrence grading system (r = 0.71, p < 0.001). Although continuous GHOA severity correlates with lower postoperative scores, the overall SOAS score alone is a poor prognostic discriminator for clinical failure. Therefore, GHOA should not be considered an absolute contraindication for ARCR. A holistic preoperative assessment integrating these critical factors is essential for optimizing clinical decision making.

Background:Rotator cuff tears are common injuries that significantly impair shoulder function and quality of life, particularly for large to massive tears, where maximal repair often results in high retear rates. Bridging reconstruction using acellular dermal allografts such as GraftJacket and AlloPatch offers a promising alternative by providing a scaffold that supports tendon healing and enhances structural stability. Although these grafts have similar biomechanical strengths, they differ in processing and biological properties, and comparative clinical outcomes remain understudied.Purpose:To compare radiologic and clinical outcomes of patients who underwent arthroscopic rotator cuff reconstruction using GraftJacket or AlloPatch allografts.Study Design:Cohort study; Level of evidence, 3.Methods:Patients who underwent arthroscopic bridging reconstruction for large to massive rotator cuff tears (>3 cm) using GraftJacket or AlloPatch were included. The primary outcome was healing assessed by magnetic resonance imaging. The secondary outcome was the Western Ontario Rotator Cuff (WORC) index. Tertiary outcomes were imaging-based structural metrics, including acromiohumeral interval (AHI), muscle atrophy (Warner grade), fatty infiltration (Goutallier-Fuchs classification), and structural integrity (Sugaya classification). Demographics, intraoperative data, and all outcome measures were compared between graft groups.Results:There were no significant demographic differences between GraftJacket (n = 49) and AlloPatch (n = 37) groups. The AlloPatch group had higher baseline supraspinatus muscle atrophy (P = .006) and fatty infiltration (P = .03) grades, along with more concurrent subscapularis repairs (P < .001). Postoperative imaging occurred at 2.22 ± 1.14 years for GraftJacket and 1.35 ± 0.70 years for AlloPatch (P < .001). Graft healing was not significantly different between groups (AlloPatch: 76%, GraftJacket: 69%; P = .52). Postoperative patient-reported outcomes were measured at 2.91 ± 0.87 years for GraftJacket and 2.64 ± 0.66 years for AlloPatch (P < .27). Both groups improved WORC scores from preoperative to postoperative assessment (P < .001), with no between-group difference (P = .97). The AlloPatch group had an increased postoperative AHI (P = .045), and the GraftJacket group did not, although the GraftJacket group had higher structural integrity (Sugaya) grades postoperatively (P = .02). No other between-group differences in imaging-based structural metrics were found.Conclusion:GraftJacket and AlloPatch dermal allografts yield comparable healing, patient-reported outcomes, and structural imaging metrics following arthroscopic bridging reconstruction for large to massive rotator cuff tears, demonstrating similar efficacy.

Introduction:Minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) are essential for interpreting patient-reported outcome measures (PROMs). However, disease-specific thresholds for acromioclavicular (AC) joint arthropathy are not well established, limiting meaningful interpretation of patient-reported outcomes.Materials and Methods:This prospective observational cohort study included adults with symptomatic AC joint arthropathy managed either conservatively or surgically. PROMs – including the Constant–Murley score, American Shoulder and Elbow Surgeons score, University of California Los Angeles score, Quick Disabilities of the Arm, Shoulder and Hand, Western Ontario Rotator Cuff (WORC) index, and visual analogue scale for pain – were collected at baseline and 12 months. MCID, substantial clinical benefit (SCB), and maximum outcome improvement (MOI) were determined using anchor-based methods with a global rating of change scale and receiver operating characteristic analysis, supported by distribution-based estimates. PASS thresholds were derived using a patient satisfaction anchor. Thresholds were calculated separately within surgical and conservative treatment contexts in accordance with Consensus-based Standards for the Selection of Health Measurement Instruments recommendations.Results:A total of 170 patients (100 conservative, 70 surgical) completed a 12-month follow-up. All PROMs demonstrated excellent reliability (intraclass correlation coefficient range, 0.85–0.96) and strong anchor validity (Spearman r, 0.51–0.62; P < 0.001). Anchor-based MCID values differed across PROMs and treatment contexts but consistently exceeded measurement error. The WORC index demonstrated the highest responsiveness (area under the curve, 0.84; standardised response mean, 0.85). PASS thresholds reflected acceptable symptom states across PROMs, and approximately 92% of patients achieving MCID also met PASS criteria. Thresholds were derived independently within each treatment context and were not intended for comparative assessment of treatment effectiveness.Conclusion:This study establishes disease-specific MCID, SCB, MOI, and PASS thresholds for commonly used shoulder PROMs in AC joint arthropathy. These benchmarks enhance the interpretability of patient-reported outcomes, support standardised reporting in clinical research, and should be applied as measurement tools rather than indicators of comparative treatment efficacy.

Post-operative pain following arthroscopic rotator cuff repair is challenging. Peripheral nerve blocks are commonly used, but debate remains over single-shot versus continuous interscalene catheters. This trial compared early post-operative pain and opioid use with a single-shot block versus a continuous interscalene catheter. In this prospective, double-blinded randomized controlled trial, 45 patients undergoing arthroscopic rotator cuff repair received an interscalene catheter with an initial single-shot block. They were randomized to either a patient-controlled infusion of normal saline (control, n = 22) or low-dose anesthetic (treatment, n = 23). Visual analogue scale for pain severity (VAS-S) and frequency (VAS-F) were assessed pre-operatively, daily for the first post-operative week, and at 2, 6, and 12 weeks. Opioid consumption was recorded for one week post-operatively. Functional outcomes were measured using the Constant and Western Ontario Rotator Cuff scores, and satisfaction with the surgery was assessed at 12 weeks. A significant interaction effect was found for VAS-S over the first week (P = .041), with the treatment group reporting significantly lower pain on day 1 (P = .011). Both groups showed significant improvement in clinical scores (P < .0001). The treatment group had a higher Constant score at 12 weeks (P = .040), though this did not reach the Minimally Clinically Important Difference. No significant difference in opioid consumption (P = .653) or satisfaction (treatment: 82%, control: 91%) was observed. Continuous interscalene catheters improved early post-operative pain without reducing opioid use. Despite these findings, careful consideration of patient needs, cost-effectiveness, and the potential complications associated with catheter use should be acknowledged in the individual patient's pain management strategy.

Does physical activity provide additional benefit in individuals with rotator cuff related shoulder pain?

Background: Rotator cuff injuries are a leading cause of upper extremity dysfunction, particularly in populations with occupational strain, such as security guards. These injuries are associated with pain, restricted range of motion, and diminished functional independence. Objective: To investigate the association between previous rotator cuff injuries and upper limb dysfunction among security guards. Methodology: An analytical cross-sectional study was conducted among 138 male security guards aged 45 to 60 years with a documented history of rotator cuff injury. A non-probability convenience sampling technique was used to recruit participants. Participants were excluded if they had a history of fractures, active infections, neurological disorders affecting cognition, or recent overhead shoulder trauma. The Disabilities of the Arm, Shoulder, and Hand scale and the Western Ontario Rotator Cuff Index were used to assess upper limb disability and shoulder-related quality of life. Clinical assessment of rotator cuff integrity was performed using the Lift-Off and the Empty Can tests. Descriptive statistics were used to present categorical variables as frequencies and percentages. The Mann–Whitney U test and Kruskal–Wallis test were used to evaluate differences in functional outcomes, while the Chi-square test was applied to determine the association between rotator cuff injury and shoulder disability among security guards. A p-value of less than 0.05 was considered statistically significant. Results: A significant proportion of participants exhibited upper extremity dysfunction, with 66.7% and 61.6% testing positive on the Lift-Off and Empty Can tests, respectively. Pain and reduced range of motion, particularly in abduction and flexion, were strongly associated with diminished occupational performance. Participants with positive test results had higher symptom severity and lower functional scores. Participants showed the symptom score by Disabilities of the Arm, Shoulder, and Hand scale, Western Ontario Rotator Cuff Index, and Sports performance across both tests showed significant results (p&gt;0.05), whereas Sports performance didn’t show significant results (p&gt;0.05). Conclusion: Rotator cuff injuries substantially impact shoulder function and occupational performance in security guards. Rotator cuff injuries are a leading cause of upper limb dysfunction, particularly in high-risk occupational groups like security guards. Almost half of the population of security guards suffered from rotator cuff injury.

Shoulder pain and shoulder surgery are increasingly prevalent and encompass a broad spectrum of pathologies, including rotator cuff disease, glenohumeral osteoarthritis, and shoulder instability. Growing evidence suggests that gender-related factors influence disease presentation, patient-reported outcomes, and postoperative recovery; however, these effects remain inconsistently reported across the literature. This current concepts review synthesizes available evidence on the influence of gender on pre-operative characteristics, non-operative management, and postoperative outcomes following common shoulder procedures, including rotator cuff repair, anatomic and reverse shoulder arthroplasty, and surgical stabilization for instability. A comprehensive literature search of PubMed, the Cochrane Library, and Google Scholar was performed for studies published through October 2025, with outcomes assessed using validated instruments such as the Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons score, Constant-Murley score, Simple Shoulder Test, Visual Analog Scale, and Shoulder Pain and Disability Index. Across shoulder pathologies, female patients consistently demonstrated worse pre-operative functional scores, higher pain levels, and greater perceived disability despite similar structural disease severity. Postoperatively, both genders experienced meaningful clinical improvement; however, females often reported higher early postoperative pain and lower absolute functional outcomes, particularly following shoulder arthroplasty for glenohumeral osteoarthritis and surgical treatment of multidirectional instability. In contrast, outcomes following rotator cuff repair and anterior instability stabilization were largely comparable between genders. Recognition of these gender-related differences is essential for individualized patient counseling, expectation setting, and optimization of management strategies, and highlights the need for future studies with robust gender-disaggregated analyses.

Arthroscopic surgical takedown and repair of symptomatic partial-thickness rotator cuff tears are commonly undertaken. An alternative approach is the use of a bioinductive collagen implant to augment the rotator cuff tear. To investigate early function and rotator cuff tendon integrity in patients undergoing arthroscopic bioinductive collagen implant augmentation (REG group) versus rotator cuff takedown and repair (RCR group) for high-grade partial-thickness rotator cuff tears. Randomized controlled clinical trial; Level of evidence, 2. Patients 35 to 75 years of age with symptoms >3 months and unresponsive to nonoperative treatment, with high-grade partial-thickness rotator cuff tears confirmed on 3-T magnetic resonance imaging (MRI), were randomly allocated to RCR or REG groups. Exclusion criteria included previous ipsilateral shoulder surgery, multitendon tears/pathology, and concomitant surgery including labral repair, long head of biceps tenodesis, or chondroplasty/microfracture. Patients were assessed preoperatively and at 6 weeks as well as 3, 6, and 12 months postoperatively. The primary study outcome was the Western Ontario Rotator Cuff Index (WORC) at 3 months after surgery. Secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) and Constant scores, and the time taken to return to work and activities of daily living (ADLs). MRI-based rotator cuff repair integrity was assessed using the Sugaya grading system. This study recruited 41 patients (REG n = 21; RCR n = 20). No group differences (P > .05) were observed in mean age (REG 57.1 years; RCR 57.8 years), preoperative duration of symptoms, and previous nonoperative treatments. The REG group reported superior outcomes for the WORC at 6 weeks (P = .001) and 3 months (P = .026) as well as the ASES at 6 weeks (P < .001) and WORC Work, Sport, and Emotions domains at 6 weeks and 3 months (P < .05). There were no group-based differences (P > .05) in patient-reported outcomes at 6 or 12 months after surgery. The REG group was faster (P < .05) to permanently remove the sling, drive a motor vehicle, and return to office duties and moderate-intensity chores. No MRI-based differences were observed, with 19 (90%) and 17 (85%) REG and RCR patients, respectively, graded Sugaya 1 to 2 at 12 months. For symptomatic high-grade partial-thickness rotator cuff tears, bioinductive collagen implant augmentation versus standard rotator cuff repair demonstrated improved early function with equivalent MRI-based healing rates. Australian New Zealand Clinical Trials Register (ACTRN12620000926932p).

Background: Rotator cuff–related shoulder symptoms are common in physically active populations, yet limited evidence exists regarding their frequency among gym beginners and their impact on quality of life. Objective: To determine the frequency of clinical findings suggestive of rotator cuff tendinopathy among gym beginners and to evaluate their association with shoulder-related quality of life. Methods: A cross-sectional observational study was conducted among 100 gym beginners aged 20–40 years in Bahawalpur. Participants were assessed using the Hawkins-Kennedy test to identify shoulder impingement–related symptoms and completed the Western Ontario Rotator Cuff Index questionnaire to evaluate quality of life. Descriptive statistics and chi-square tests were used for analysis. Results: A total of 56% of participants tested positive on the Hawkins-Kennedy test (95% CI: 46–66%). All participants with negative findings reported best quality of life, whereas 98.2% of positive cases had mildly affected quality of life and 1.8% had severe impairment (p &lt; 0.001). Female participants showed a higher prevalence of positive findings compared to males (80% vs 40%; OR = 6.0, 95% CI: 2.5–14.4). Conclusion: A high proportion of gym beginners demonstrated clinical signs suggestive of rotator cuff–related shoulder involvement, which was strongly associated with reduced quality of life. These findings highlight the importance of early screening and preventive strategies in novice gym populations.

Large or massive rotator cuff tears comprise 10–40% of all cases, with considerable debate on the best treatment approach. These complex injuries often involve multiple tendon tears and can lead to substantial pain, loss of function, and disability. Selecting the optimal surgical technique for these injuries has been widely debated, as each approach has unique advantages and limitations. Bridging rotator cuff reconstruction (BRR) and superior capsular reconstruction (SCR) are two established techniques aimed at restoring shoulder balance and function. BRR uses grafts to bridge the gap between torn tendons, while SCR focuses on reconstructing the superior capsule to maintain joint integrity. Both methods have shown promising clinical outcomes, yet only limited studies have directly compared them. This study aimed to evaluate functional and self-reported outcomes in patients who received BRR or SCR using human dermal allograft. In this randomized control trial, 60 patients with large (&gt; three cm), two-tendon rotator cuff tears were randomized into the SCR or BRR group. All patients completed patient reported outcomes (PROs) (Western Ontario Rotator Cuff Index (WORC) and Disabilities of the Arm, Shoulder, Hand (DASH)) as well as strength and range of motion (ROM) of the shoulder pre- and post-operatively (six-, 12-, 24-months). PROs and functional outcomes were statistically analyzed between and within groups at each time point, respectively. Significance was set to 0.05. Patients in both groups had similar demographics (p&gt;0.05). All groups demonstrated significant improvement in WORC and DASH post-operatively at six, 12-, and 24-months from baseline (p &lt; 0 .001). At baseline, six-, and 12-months, WORC was not significantly different between groups, however, post-operatively at 24-months, BRR group had a significantly greater outcome (19.65 ± 18.8) than the SCR group (32.33 ± 20.92) (p=0.034). There were no significant differences for DASH between the two groups at any time. There were no significant differences in strength between groups at any time point, with both showing minimal, non-significant improvement at six months post-operation. At 12 months post-operation, both groups began showing significant improvements, with the SCR group gaining in abduction, internal rotation, and flexion, and the BRR group in flexion only. By 24 months, the SCR group continued to improve in abduction, external rotation, and flexion, while the BRR group showed significant gains in external rotation, internal rotation, and flexion. Average strength improvements were about 5 lbs for the SCR group and 4.5 lbs for the BRR group. No significant differences in ROM were found. This study demonstrates that both BRR and SCR using human dermal allograft significantly improve patient-reported outcomes, and strength in patients with large rotator cuff tears. While both groups experienced significant improvements, the BRR group showed slightly greater functional gains over time, suggesting that BRR with dermal allograft may offer some advantages in terms of recovery and shoulder performance. Long-term follow-up studies are warranted to further investigate the durability of these outcomes. This study contributes valuable data to the ongoing discussion regarding optimal treatment for large rotator cuff tears and supports the continued use of BRR and in clinical practice.

To compare the acute effect on exercise-induced hypoalgesia (EIH) between isometric exercise with blood flow restriction (BFR) and isometric exercise alone in adults undergoing arthroscopic RC repair and to determine the level of correlation between EIH and kinesiophobia, disability and quality of life. Blinded randomized crossover clinical trial. Twenty-three adults with degenerative rotator cuff (RC) repair. Patients completed three shoulder isometric exercises. They were randomized to receive isometric exercises alone (control intervention) or isometric exercises with BFR (experimental intervention) in the first session and the alternate condition in the next session. Primary outcomes included pressure pain threshold (PPT) and conditioned pain modulation (CPM), assessed before, immediately after, and 10 min after isometric exercises with BFR and isometric exercises alone. In the affected limb, BFR isometric exercises increased PPT immediately after exercise in upper trapezius (MD: 0.4 kg/cm2 [CI95% 0.1 to 0.9]), and in the unaffected limb, BFR isometric exercises increased deltoid PPT immediately after exercise (MD: 0.4 kg/cm2 [CI95% 0.1 to 0.7]). However, post hoc between-group comparisons showed that no significant differences existed between BFR and control at any time point, as all CI95% crossed zero and these changes did not exceed the minimum detectable change (≈1.1 kg/cm2). Besides, isometric exercise alone increased deltoid CPM immediately after in affected limb (MD: 30.1% [CI95% 10.8 to 49.4]) and 10 min after exercise in unaffected limb (MD: 12.0% [CI95% -0.4 to 24.4]). No significant changes were found in clinical pain intensity measured by the visual analog scale (VAS) at any time point. Statistically significant weak correlations were found between PPT with Western Ontario Rotator Cuff (WORC) index (r = -0.322 for sport, r = -0.331 for work, r = -0.302 for lifestyle; p < 0.05) and Shoulder Pain Disability Index (SPADI) (r = -0.309; p < 0.05), respectively. A single session of low-intensity isometric exercises with BFR did not produce a clinically meaningful EIH response nor was it superior to isometric exercise alone in patients after RC repair. The observed statistical signals did not reach the minimum detectable change, and the inconsistent CPM shifts suggest that BFR does not provide an additional acute advantage for endogenous pain modulation in this early postoperative stage. Trial Registration: ClinicalTrials.gov identifier: NCT06924112.

Background:Exercise therapy is recommended for the initial treatment of individuals with rotator cuff tears but fails in 25% to 50% of cases. Determining the baseline factors associated with patient-reported outcomes and tear propagation immediately following exercise therapy may improve treatment decision-making.Purpose:To prospectively identify factors associated with tear propagation and patient-reported outcomes immediately following a 12-week personalized exercise therapy program in individuals with symptomatic isolated supraspinatus tears.Study Design:Cohort study; Level of evidence, 2.Methods:In total, 109 individuals were recruited for this prognostic prospective longitudinal cross-sectional study and underwent a 12-week personalized exercise therapy program for the treatment of rotator cuff tears. Individuals underwent assessments of passive glenohumeral range of motion (ROM), isometric muscle strength (internal and external rotation and abduction), and glenohumeral arthrokinematics during scapular plane abduction immediately before the initiation of exercise therapy. Immediately before and after the exercise therapy program, tear size was quantified using ultrasound (propagation defined as tear size change ≥4.6 mm), and individuals completed the Western Ontario Rotator Cuff (WORC) Index score. Logistic and multiple linear regression were used to determine if baseline glenohumeral contact path length, tear size, passive glenohumeral ROM, and isometric strength were predictors of tear propagation and patient-reported outcomes immediately following exercise therapy.Results:Overall, 7 individuals (8.5%) experienced tear propagation immediately following exercise therapy. Logistic regression analysis indicated that baseline tear size was the only predictor associated with tear propagation immediately following exercise therapy. There was a 29.0% decrease in the odds of tear propagation for each 1.0-mm increase in baseline tear size (odds ratio, 0.71; 95% CI, 0.51-0.99; P = .04). Higher baseline isometric internal rotation strength predicted higher WORC scores (P = .044).Conclusion:Immediately following a 12-week personalized exercise therapy program, the percentage of individuals who experienced tear propagation was low, and baseline tear size and higher internal rotation strength were associated with tear propagation and WORC scores, respectively. Thus, the current study identified factors immediately before exercise therapy that affect tear propagation and WORC scores following an exercise therapy program.

Despite technical and material improvements in rotator cuff repair, clinical and radiological failure remains common. Following suture fixation, tension and footprint compression decrease from time zero. A novel suture has been designed to shorten when submerged in liquid to maintain tension and increase repair construct security. The aim of this study was to assess the safety and clinical outcomes (IDEAL 2a assessment) in patients receiving rotator cuff repair with the self-tensioning suture with a minimum of 12 months follow up. Clinical registries allow early identification of outlier or poorly performing prosthesis with prevention of avoidable complications. A cohort analysis was performed utilizing patients from the PRULO (Patient Reported Outcomes in Upper Limb Surgery) registry. All patients with the suture of interest who underwent a rotator cuff repair with 12 months follow up were included. Results included patient reported outcome scores: Quick Disability of the Arm, Shoulder and Hand (QuickDASH), and the Western Ontario Rotator Cuff Index (WORC) and complications. Patient reported outcome measures (PROMs) were analyzed using multiple imputation and a linear model to assess changes over 12 months follow up. A cohort of 255 patients was included for analysis. At 12 months follow up, median scores for QuickDASH decreased by 36 and WORC increased by 41, both of which surpass the minimum clinically important difference. Our observed rates of complications included: Infection 2.4%, stiffness/capsulitis 13%, and retear 12%. Complication rates and functional improvements were similar to other studies. These results suggest the suture is safe and adequately effective for ongoing clinical use and further study. The novel suture demonstrated comparable safety and efficacy profiles, with outcomes similar to those published in the literature. This study suggests this novel suture is safe and does not seem to produce unique complications. Further research is warranted to specifically investigate clinical efficacy in the longer term. ACTRN12619000770167.

Kinesio tape (KT) is being applied increasingly in physical therapy and rehabilitation. This trial aimed to examine the effect of KT in terms of functional outcomes in people undergoing arthroscopic rotator cuff repair (ARCR). KT after ARCR will reduce pain and edema. A double-blind, randomized controlled trial. Level 1b. A total of 45 patients who underwent ARCR were assigned randomly to 1 of 3 groups: KT (n = 15), sham taping (ST, n = 15), and control (n = 15). Participants received a conservative physiotherapy program. The physiotherapy program, which was conservative in nature, covered the first 7 weeks after surgery. In addition to the program, patients in the KT group were also treated with KT, while those in the ST group received ST. Pain levels (visual analog scale), edema, and functional scores (Western-Ontario Rotator Cuff Index, Modified Constant-Murley Shoulder Score, Revised Oxford Shoulder Score, and Shoulder Pain and Disability Index) were evaluated at regular intervals throughout the treatment. Baseline characteristics of the groups were similar (P > 0.05). All evaluation parameters showed significant improvement over time in all 3 groups (P < 0.05). There were no differences between the groups in any of the parameters when analyzed for group × time interactions (P > 0.05). This study found no efficacy of KT after ARCR in reducing pain and edema and improving shoulder function in the short- or medium-term. Clinicians should not expect additional short- or medium-term benefits from KT in reducing pain and edema or improving shoulder function after ARCR.

Translation, cross-cultural adaptation, validation and reliability of Western ontario rotator cuff index in Punjabi language.

Shoulder injuries involving the rotator cuff are prevalent and often require surgical intervention. Rotator cuff repair procedures have historically faced challenges, including varying healing outcomes and high retear rates. However, recent advancements involve the use of augmented patches to enhance tendon-to-bone insertion, either mechanically or biologically. Existing literature supports the favorable outcomes associated with augmented patch techniques. Yet, no study has directly compared the results of augmentation and traditional rotator cuff repair methods. This study aims to assess the outcomes of patients who underwent either rotator cuff repair or augmentation procedures at a minimum of one year postoperatively. The evaluation utilizes patient-reported outcome scores and postoperative healing assessments through MRI. Our hypothesis is that individuals who underwent augmentation procedures would exhibit better healing and patient-reported outcomes. We conducted a retrospective analysis of 131 patients who underwent either rotator cuff repair (RCR) (N=42) or augmentation procedures (AUG) (N=21) between 2015 and 2022. The AUG group comprised 21 patients, with the remaining RCR patients matched for age and gender (2:1 ratio) to the AUG group. Data collected included pre- and post-operative MRIs, Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The primary outcome measure was healing, determined using MRI, with secondary outcomes being WORC and DASH scores. There were no significant differences between the groups regarding age, BMI, or sex (p&gt;0.05). The mean postoperative MRI follow-up was 1.27 + 0.8 years for the RCR group and 1.3 + 1.0 years for the AUG group (p &gt; 0.05). The AUG group demonstrated superior graft healing rates compared to the RCR group. Specifically, 92% of patients in the AUG group showed complete healing, with only 0.8% partially healed. In contrast, the RCR group exhibited full healing in 63% of patients, partial healing in 21%, and 25% of patients did not demonstrate any healing. Pre- and post-operatively, there were no differences in WORC or DASH scores between the two groups (p&gt;0.05). Overall, both procedures significantly improved patient-reported outcomes (WORC &amp; DASH) postoperatively (p&lt; 0.05). The use of augmented patches for tendon-to-bone insertion, as observed in the AUG group, resulted in superior graft healing rates compared to traditional RCR. However, there were no significant differences between the groups in terms of patient-reported outcome scores (WORC and DASH). This suggests that both procedures led to similar improvements in functional outcomes. Further research is necessary to directly compare the efficacy of augmentation and RCR techniques in treating rotator cuff injuries.

BackgroundPoly-lactic co-glycolide with tricalcium phosphate (PLGA)/β-TCP is both bioactive and biodegradable, and is considered a third generation biomaterial for suture anchors. This study aims to describe the incidence of adverse events and the trajectory of patient-reported outcomes up to 12 months follow up in patients undergoing rotator cuff repair with this type of anchor.MethodsA sub-group analysis of a prospective registry of a regional private clinic embedded in an orthopaedic clinic was conducted. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12619000770167) with date 23/05/2019. Patients undergoing surgery from Jun-2020 to Mar-2024 with the Healix Advance BR were identified and data on patient demographics, treatment details, complications and adverse events, as well as patient-reported outcome measures (PROMs) were retrieved. Summary statistics were generated for patient characteristics and PROMs analysed using multiple imputation and mixed-effects linear models to assess changes between baseline and 12 month follow up.ResultsA consecutive cohort of 68 cases receiving the anchor of interest was included for analysis. Complications were recorded in six cases (8.8%, 95%CI 3.6–18.9), presenting as postoperative capsulitis/stiffness (N = 3), persistent shoulder pain (N = 1), a case of hemi-diaphragm palsy and a case of complex regional pain syndrome in the hand. No infections or reoperations were encountered in this series. The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores improved significantly from 42 (IQR 32–52) preoperatively to 5 (IQR 2–14) at 12 months. Western Ontario Rotator Cuff (WORC Index) scores improved from 35 (IQR 21–54) preoperatively to 88 (IQR 70–95) at 12 months.ConclusionsThis study found a low incidence of adverse events, no requirement for reoperation or revision, and favourable recovery of patient-reported outcomes in patients treated with arthroscopic rotator cuff repair with a third-generation biocomposite suture anchor at up to 12 months follow up.Trial registrationEthics approval for the Patient Registry of Upper Limb Pathology Outcomes (PRULO) has been provided by the Human Research Ethics Committee at Barwon Health (Project ID 49184, Reference 19/70). This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12619000770167) with date 23/05/2019.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12891-025-09233-3.

ObjectiveThe study compares adjustable plastic braces fixed at 45° abduction versus sponge abduction packs for their effects on short-term pain and functional outcomes following arthroscopic rotator cuff repair, while analyzing the feasibility of replacing sponge abduction packs with plastic braces.MethodsA total of 48 patients were recruited between April and July 2024 and stratified by gender into 4 groups: plastic brace group and sponge abduction pack group (12 patients each). At 3 weeks post-operation, follow-up was conducted using the Western Ontario Rotator Cuff Index (WORC) as the primary measure for shoulder joint function, and Visual Analog Scale (VAS), Range of Motion (ROM), Pittsburgh Sleep Quality Index (PSQI), and Short Form 12 (SF-12) as secondary measures for pain, mobility, sleep quality, and quality of life.ResultsA total of 44 patients were enrolled, 23 in the plastic brace group and 21 in the sponge abduction pack group. At 3 weeks postoperatively, significant between-group differences were observed in abduction angle (78.5 ± 7.9 vs. 72.9 ± 7.2, P = 0.02), whereas WORC scores showed no statistical significance (90.1 ± 24.0 vs. 71.8 ± 29.1, P = 0.22).In subgroup analysis by gender, the difference in WORC score was statistically significant between sponge abduction pack and plastic brace groups in females (70.0 ± 29.1 vs. 100.7 ± 19.6, P = 0.03).ConclusionThe use of a plastic brace instead of a sponge abduction pack after rotator cuff repair shows potential feasibility and results in a greater abduction angle in the early rehabilitation period. In addition, the plastic brace showed better clinical outcomes than the sponge abduction pack especially in females.Trial registrationChinese Clinical Trial Center (ChiCTR2500095943),20,250,115.

BackgroundAcromioplasty is frequently performed during arthroscopic rotator cuff repair (ARCR) to address subacromial impingement, though its clinical value remains debated. This meta-analysis examines whether acromioplasty improves functional outcomes, pain relief, or re-tear rates in patients undergoing ARCR for full-thickness rotator cuff tears.MethodsA systematic search of PubMed, Embase, Cochrane Library, and Scopus was conducted in accordance with PRISMA (Preferred Reporting Items for Sys­tematic Reviews and Meta-Analyses) guidelines to identify randomized controlled trials (RCTs) from 2011 to 2023. Six RCTs comparing ARCR with and without acromioplasty were included. Primary outcomes included functional scores of American Shoulder and Elbow Surgeons (ASES), Western Ontario Rotator Cuff Index, University of California, Los Angeles scores, pain levels (visual analog scale [VAS]), and re-tear rates. Data were pooled using a random-effects model. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsAcross 574 patients, both groups demonstrated improvement in functional outcomes. The acromioplasty group showed a modest advantage (e.g., ASES score: mean difference, 2.93), but these gains did not exceed the minimal clinically important difference. There were no significant differences in pain relief (as measured by VAS) or re-tear rates between groups. The risk of bias was moderate in some trials due to a lack of blinding. GRADE assessment rated evidence as high for ASES scores and moderate for other outcomes.ConclusionsAcromioplasty offers statistically modest improvements in shoulder function but does not meaningfully enhance pain relief or reduce re-tear rates. Given these findings, the routine use of acromioplasty in ARCR is not supported; however, select patients may benefit based on individual anatomical or clinical factors.Level of evidenceI.