Early mobilisation following mini-open rotator cuff repair

Abstract

This study compared the clinical outcomes following mini-open rotator cuff repair (MORCR) between early mobilisation and usual care, involving initial immobilisation. In total, 189 patients with radiologically-confirmed full-thickness rotator cuff tears underwent MORCR and were randomised to either early mobilisation (n = 97) or standard rehabilitation (n = 92) groups. Patients were assessed at six weeks and three, six, 12 and 24 months post-operatively. Six-week range of movement comparisons demonstrated significantly increased abduction (p = 0.002) and scapular plane elevation (p = 0.006) in the early mobilisation group, an effect which was not detectable at three months (p > 0.51) or afterwards. At 24 months post-operatively, patients who performed pain-free, early active mobilisation for activities of daily living showed no difference in clinical outcomes from patients immobilised for six weeks following MORCR. We suggest that the choice of rehabilitation regime following MORCR may be left to the discretion of the patient and the treating surgeon.

Effectiveness of early compared with conservative rehabilitation for patients having rotator cuff repair surgery: an overview of systematic reviews

“…Seven studies were included in our meta-analysis. Two RCTs31 39 were excluded as they assessed patients with traumatic tears. The flow diagram (figure 2) describes the selection process.…”

Protocol for a multi-centre pilot and feasibility randomised controlled trial with a nested qualitative study: rehabilitation following rotator cuff repair (the RaCeR study)

“…The pooled odds ratio of tendon re-tear in the early rehabilitation group was 1.3 (95% confidence interval: 0.72–2.2; p = 0.41), which suggests that patients undergoing early rehabilitation were slightly more likely to have a tendon re-tear than those in the delayed rehabilitation group but the difference was not statistically significant. Subsequent to the systematic review, a Canadian RCT ( n = 189) compared early rehabilitation (patient-led mobilisation or movement of the shoulder) with sling immobilisation following RC repair [17]. This trial did not restrict inclusion by size of RC tear and concluded that the range of movement of the shoulder was better at 6 weeks in the early rehabilitation group, but there were no significant differences between groups at 3, 6, 12 or 24 months, indicating that early rehabilitation might result in a faster recovery without detrimental effects in the longer term.…”

Rehabilitation following shoulder arthroplasty in the United Kingdom National Health Service: A survey of publicly facing information

“…Currently, the only clear consensus appears to be the recognition that high-quality research is needed to better inform practice and optimise clinical outcomes for patients following SA (Bullock et al, 2019;Kirsch & Namdari, 2020). Other areas of rehabilitation following orthopaedic surgery, for example, rehabilitation following rotator cuff repair, have evolved over a number of years (Littlewood et al, 2019;Sheps et al, 2015;Sheps et al, 2019). Whether there is now further opportunity to develop rehabilitation approaches, following SA, to enhance clinical outcomes and/or reduce postoperative restrictions, for example, sling immobilisation, is a question to be addressed.…”