Effect of abduction brace wearing angle on clinical outcomes after arthroscopic repair of large repairable rotator cuff: a retrospective study.

Abstract

Rotator cuff tears affect approximately 20% of the population and are usually repaired arthroscopically. The clinical outcomes of these repairs are influenced by multiple factors, including patient characteristics, surgical technique, and postoperative management. Postoperative shoulder posture, particularly the degree of abduction, plays an important role in repair site tension and tendon-bone healing. This study aimed to evaluate the clinical outcomes and repair integrity of patients undergoing arthroscopic repair of large rotator cuff tears using a 30° and 45° abduction brace. A total of 82 patients with symptomatic full-thickness rotator cuff tears were included in this study. The control group included 40 patients using a 30° brace, and the study group included 42 patients using a 45° abduction brace. Visual analogue scales (VAS) and humerohumeral range of motion were obtained before surgery and at 1 month (M1), 3 months (M3), and 6 months (M6) after surgery. Shoulder function scores (including Constant-Murley (CMS), University of California, Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores) and retear rates were assessed at final follow-up (24 months). Early passive ROM (flexion at 1 month, abduction at 1 and 3 months, external rotation at 1 and 3 months) was significantly better in the study group (45° abduction brace, P < 0.05). At 24 months, there were no significant differences in shoulder range of motion, function scores, and retear rates between the two groups (P > 0.05). Of note, in subgroup analysis, the retear rate was lower with a 45° brace than with a 30° brace under moderate to severe repair tension (16.67% vs. 44.44%, P < 0.05). These results suggest that immobilization with a 45° brace rather than a 30° abduction brace after arthroscopic repair of large rotator cuff tears results in better passive range of motion during early follow-up, particularly with lower retear rates at moderate to severe repair strains.