Difference in early postoperative stiffness and pain after arthroscopic rotator cuff repair: bio-absorbable versus non-absorbable titanium and PEEK implants

Rationale: Rotator cuff lesions are not rare and can lead to unexplained pain
and considerable disability, incidence varying between 10 to 35 %. Good to
excellent results in arthroscopic rotator cuff repair are published but little
has been said about complication rates, especially with regard to post
operative stiffness and pain. In our clinic we experience a higher degree of
postoperative pain and shoulder stiffness 3-6 months postoperative in patients
undergoing arthroscopic rotator cuff repair using bio-degradable anchors
compared to titanium or synthetic anchors. The aim of our study was to evaluate
outcomes in early postoperative shoulder stiffness and postoperative pain in
patients undergoing arthroscopic rotator cuff repair, prospectively. The use of
bio-degradable anchors may result in higher rate of postoperative shoulder
stiffness and pain than is associated with the use of titanium or synthetic
anchors in arthroscopic rotator cuff repair. We also want to evaluate
cost-effectiveness of the three different types of anchors used.

1. To assess the correlation between the use of bioabsorbable anchors and the
early postoperative rate of shoulder stiffness in comparison to the use of
non-absorbable titanium and synthetic (PEEK) anchors in arthroscopic rotator
cuff repair.
2. To assess the postoperative rate of early shoulder stiffness following
arthroscopic rotator cuff repair.
3. To assess success rate of operation (functional outcome and postoperative
tendon integrity) and complication.
4. To asses differences in postoperative pain and patient satisfaction.
5. To asses cost-effectiveness of the three different types of anchors used.

Prospective, randomized, controlled study

Supraspinatus lesions were repaired using a standardized arthroscopic approach
and a double row technique. Patients were randomized to receive commercially
available absorbable (n=30), titanium (n=30) or synthetic anchors (n=30).

The burden for the participants consists of normal outpatient visits of a
proximal 5 minutes: pre operative, 1, 3, 6, 12 weeks, * and 1 year. All
assessments are non-invasive nad standart to patients clinicaly treated before.
To asses shoulder stiffness, pre and postoperative shoulder Range Of Motion
(ROM) will be tested: pre-operative, 3, 6 weeks, 3, 6 and 12 months
postoperative. Patients are asked to fill in the Oxford Shoulder Score a twelve
question questionnaire: pre and 3 months postoperative.
This study does not impose more, peri and postoperative, risk to the patient
than is seen in clinical performed arthroscopic rotator cuff repair. The study
will not provide personal benefits participating patients but future patients
might benefit from the results of the study performed.

Ultimately this will result in more insight in and less postoperative stiffness
in patients undergoing rotator cuff repair