The Efficacy of Synovectomy in Rotator Cuff Repair: A Randomized Controlled Trial.

BACKGROUND

Synovitis is frequently observed in patients with rotator cuff tears and has been associated with increased pain and inferior clinical outcomes. Although synovectomy has demonstrated clinical benefits in primary synovial disorders, its role as an adjunctive procedure during arthroscopic rotator cuff repair remains controversial, particularly regarding early postoperative pain relief.

PURPOSE: To evaluate the effect of synovectomy on clinical outcomes after arthroscopic rotator cuff repair.

STUDY

DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

This prospective randomized controlled trial included 60 patients with full-thickness rotator cuff tears who underwent arthroscopic rotator cuff repair between March 2017 and May 2018. Patients were randomly assigned to undergo rotator cuff repair with synovectomy (n = 30) or without synovectomy (n = 30). The primary outcome was worst pain measured using a 10-cm visual analog scale (VAS) at 3 months postoperatively. Secondary outcomes included other pain measures, range of motion, rotator cuff muscle strength, functional outcome scores, and patient-reported satisfaction. Outcomes were assessed preoperatively and at 3 months postoperatively by blinded assessors.

RESULTS

Worst pain VAS scores significantly improved from baseline to 3 months postoperatively in both groups (P < .05), with no significant between-group difference in the magnitude of improvement (P = .79). No significant between-group differences were observed at 3 months in any pain measure, range of motion, rotator cuff muscle strength, functional outcome scores, or overall satisfaction. Although supraspinatus strength decreased significantly from baseline only in the control group, the between-group difference in strength change was not significant.

CONCLUSION

Synovectomy performed during arthroscopic rotator cuff repair did not provide additional short-term benefits in pain relief, functional recovery, or patient satisfaction at 3 months postoperatively. These findings do not support the routine use of synovectomy as an adjunctive procedure to improve early postoperative outcomes after rotator cuff repair.

REGISTRATION: NCT03061942 (ClinicalTrials.gov identifier).