Risk, incidence, and outcomes of postoperative frozen shoulder.

Abstract

Purpose: Frozen shoulder and shoulder stiffness are two potential complications following shoulder surgery. These present during an until then normal rehabilitation period and can have a profound effect on patient quality of life. This retrospective file audit is a pilot study examining incidence, prognostic factors, and effective managements. This is yet to be investigated in Australia and the results will form the basis for a larger project in the future. Method: 129 consecutive patients who underwent arthroscopic shoulder surgery or mini-open rotator cuff repair from July 2015 to July 2017 were included in this study. 25 patients underwent capsular release for primary frozen shoulder and were considered a separate group. Patient demographics, operation details, and details of follow up were collected from patient files. Results: 43/104 (41.3%, 95% CI = 31.8 to 51.4%) patients experienced postoperative stiffness following arthroscopic surgery. Follow-up for stiff patients had a median of 6 months (95% CI = 4.8 to 7.2 months) while non-stiff patients were followed up for a median of 3 months (95% CI = 2.0 to 4.0 months), this difference being statistically significant (p < 0.001) according to median quantile regression. 24 patients underwent hydrodilatation for their stiffness, 4 underwent capsular release. 15/25 (60.0%, 38.7% to 78.9%) patients undergoing capsular release experienced postoperative stiffness. Conclusion: Postoperative frozen shoulder is a prevalent complication of arthroscopic surgery with an incidence of 41%. The majority of patients underwent hydrodilatation for treatment. Stiff patients required follow-up for twice as long as their non-stiff counterparts.