The addition of suprascapular nerve release to rotator cuff repair does not always provide significant improvements in functional outcomes or pain relief, new research suggests.
Suprascapular Nerve Release Not Needed for Rotator Cuff Repair
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#rotatorcuffrepairSecondary#patientreportedoutcomes#suprascapularnerverelease
The study, “Does Suprascapular Nerve Release Provide Additional Benefits for Rotator Cuff Repair: A Systematic Review and Meta-Analysis” was published online on June 20, 2022 in the Journal of Shoulder and Elbow Surgery.
“There is still a lack of consensus regarding whether suprascapular nerve decompression should be routinely performed with rotator cuff repair,” the researchers wrote.
To get a clearer answer, they conducted a literature review of nine studies on the effect of suprascapular nerve release on 279 patients who underwent rotator cuff repair. The average age of patients was 52.7 years. Outcome measures analyzed included American Shoulder and Elbow Surgeons scores, University of California, Los Angeles shoulder scores, Constant scores, and Visual Analog Scores (VAS) for pain.
All patients saw significant improvements between preoperative and postoperative shoulder function scores; however there appeared to be significant change in functionals scores between those who also underwent suprascapular nerve release and those who did not. Also, there was no significant differences in the VAS pain scores between the two groups.
The researchers also found no significant differences in the retear rates between the group with suprascapular nerve release and the group without it.
“Our meta-analysis showed that suprascapular nerve released did not provide additional benefits in patients undergoing rotator cuff tendon repair. Suprascapular nerve release is not recommended as a routine procedure for rotator cuff tendon repair but should be considered in those who have a high risk of suprascapular nerve entrapment,” the researchers wrote.
Study authors included Hsuan-Hsiao Ma and I-Chen Tsai of the National Yang Ming Chiao Tung University and Wei-Ting Wu and Ke-Vin Chang of the National Taiwan University Hospital.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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