Do We Have to Perform Surgical Treatment Simultaneously for Rotator Cuff Tear in Patients with Adhesive Capsulitis?

Purpose: Retrospectively, the purpose of this study is to investigate the necessity for early operation for patients with rotator cuff tears and concomitant adhesive capsulitis. Methods: From March 2013 to March 2017, we conducted a retrospective study on patients with rotator cuff tears and concomitant adhesive capsulitis. We analyzed 32 cases out of 39 cases who have small to medium rotator cuff tears, excluding patients who were unable to follow up over 1 years. We evaluated range of motion, visual analog scale (VAS) score, and Constant score. We compared patients of non-symptom and symptomatic patients related to rotator cuff tear. Results: Among patients in the 32 cases, 21 cases of total patients improved without discomfort after recovering their range of motion and pain (group 1), and 11 cases were developed symptoms related to rotator cuff tear for the last 1 year (group 2). Average age of group 1 patients was 53.4 years old, and recovered from forward elevation 95.5 to 163.2, external rotation from 8.5 to 68.7, mean VAS score improved from 6.2 to 1.2. Average age of group 2 patients was 58.4 years old, and recovered from forward elevation 96.2 to 162.2, external rotation from 8.1 to 67.8, mean pain VAS score improved from 6.4 to 4.4. But there was statistically significant difference in pain reduction after restoration of motion compared to asymptomatic group. Conclusion: We do not need surgical treatment at the same time because the symptoms of rotator cuff tear may not be manifested in patients with rotator cuff tear associated with adhesive capsulitis. Sufficient follow-up should be considered after restoration of shoulder motion related to adhesive capsulitis.