{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:32:24Z","timestamp":1790443944894,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to compare the outcomes of arthroscopic rotator cuff repair (ARCR) in patients with preoperative stiffness to those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 135 patients were prospectively evaluated for 2 years after ARCR for small to medium sized rotator cuff tears at our institution. Patients were divided into stiff (&lt;100\u00b0 of passive forward flexion) and non\u2010stiff cohorts. The stiff group underwent manipulation under anesthesia (MUA) before ARCR was performed. Outcomes were measured using visual analog scale (VAS), Constant Shoulder Score (CSS), and Oxford Shoulder Score (OSS) recorded at the preoperative, 6\u2010 , 12\u2010, and 24\u2010month time points. The results of ARCR between the cohorts were then compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 123 out of 135 patients (91.1%) completed the follow\u2010up (stiff n\u00a0= 46, non\u2010stiff n\u00a0= 77). There were significant improvements in the mean CSS scores at 6 (mean, 59.87;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and 12 months (mean, 65.88;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .021) in the stiff group. There were no significant differences detectable in the CSS and OSS scores between the stiff and non\u2010stiff groups at 6, 12, and 24 months. However, the percentage of patients achieving minimal clinically important difference was significantly higher in the stiff group (97.8%) compared with the non\u2010stiff group (75.3%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001). The VAS scores, forward flexion, and strength in both groups were found to be comparable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of our study showed no significant differences in outcomes scores in patients with stiff shoulders who underwent MUA combined with ARCR compared with patients with non\u2010stiff shoulders who underwent ARCR alone. Therefore, early surgical repair should be considered in patients with rotator cuff tears and concomitant shoulder stiffness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2020.06.025","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T20:58:20Z","timestamp":1594155500000},"page":"2954-2961","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Outcomes of Arthroscopic Rotator Cuff Repair in Stiff Shoulders are Comparable to Non\u2010Stiff Shoulders When Combined With Manipulation Under Anesthesia"],"prefix":"10.1002","volume":"36","author":[{"given":"Junren","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeow Boon","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denny Tjiauw Tjoen","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Singapore General Hospital 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