Effect of Two Rehabilitation Protocols on Range of Motion and Healing Rates After Arthroscopic Rotator Cuff Repair: Aggressive Versus Limited Early Passive Exercises

Lee, Bong Gun; Cho, Nam Su; Rhee, Yong Girl

doi:10.1016/j.arthro.2011.07.012

Cited by 194 publications

(197 citation statements)

References 28 publications

Supporting

Mentioning

183

Contrasting

Unclassified

Order By: Relevance

“…Data are conflicting on which, if any, of these programs provides superior results. Early aggressive rehabilitation programs have been shown to result in better early outcomes, pain relief, and range of motion however most studies show no difference with regard to these parameters with longer-term followup [60][61][62][63][64][65][66] . One concern with early aggressive rehabilitation programs is that they may be associated with a higher incidence of tendon re-tear.…”

Section: Rehabilitationmentioning

confidence: 99%

“…Like the basic science literature, the clinical literature is also conflicting as to whether the rehabilitation program utilized affects clinical healing rates after rotator cuff repair. While some studies show higher re-tear rates with early, aggressive therapy protocols, others show a trend or no difference in re-tear rates [62,63] . In a prospective randomized study of early aggressive vs delayed rehabilitation protocols, Cuff et al [63] demonstrated a slightly higher but non statistically significant re-tear rate at 1 year in the early group (15%) compared to the delayed group (9%).…”

Section: Rehabilitationmentioning

confidence: 99%

“…In a prospective randomized study of early aggressive vs delayed rehabilitation protocols, Cuff et al [63] demonstrated a slightly higher but non statistically significant re-tear rate at 1 year in the early group (15%) compared to the delayed group (9%). Lee et al [62] evaluated re-tear rates at 6 mo comparing aggressive with conservative rehabilitation protocols. They found that the re-tear rate was significantly higher in the more aggressive group (23.3%) compared with the conservative group (8.8%).…”

Section: Rehabilitationmentioning

confidence: 99%

See 2 more Smart Citations

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

158

View full text Add to dashboard Cite

Rotator cuff repair has been shown to have good longterm results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. Core tip: Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscletendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing after rotator cuff repair. Smoking cessation and blood glucose and cholesterol control are methods to potentially improve healing rates. Slower, less aggressive rehabilitation programs may improve healing rates with no negative effect on final range of motion and are therefore recommended after arthroscopic repair of most full thickness tears. Finally, no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates after rotator cuff repair. Routine use of these adjuvants is therefore not currently recommended.

show abstract

Section: Rehabilitationmentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

See 1 more Smart Citation

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

158

View full text Add to dashboard Cite

show abstract

“…However, most of ADL and sports activities require dynamic arm movements, and some recent findings encourage early mobilisation after rotator cuff repair (Cuff and Pupello, 2012;Duzgun et al, 2011;Lee et al, 2012). Fluoroscopy-based experiments have been used to measure glenohumeral translations during dynamic tasks (Bey et al, 2008;Bishop et al, 2009;Giphart et al, 2013;Matsuki et al, 2012;Nishinaka et al, 2008) with an accuracy between 0.2 mm and 0.3 mm (Giphart et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Glenohumeral translations during range-of-motion movements, activities of daily living, and sports activities in healthy participants

Maso

Raison

Lundberg

et al. 2015

Clinical Biomechanics

View full text Add to dashboard Cite

P. et al. (2015) Glenohumeral translations during range-of-motion movements, activities of daily living, and sports activities in healthy participants.. Findings: During range-of-motion movements, maximum upward translation was 7.5 mm (P1) and 4.7 mm (P2). Upward translation during elevations was smaller with the arm internally (3.6 mm (P1) and 2.9 mm (P2)) than neutrally (4.2 mm (P1) and 3.7 mm (P2)) and externally rotated (4.3 mm (P1) and 4.3 mm (P2)). For activities of daily living and sports activities, only anterior translation during reach axilla for P1 and upward translation during ball throwing for P2 were larger than the translation measured during range-ofmotion movements (108% and 114%, respectively).

show abstract

“…10 Arthroscopic repairs of cuff tears of shoulder is an established method of treatment with reproducible results, 4,11,12 considering that the post operative rehabilitation is as important as the repair itself. 3,12,13 In our study twenty five patients, underwent the procedure of all arthroscopic rotator cuff repair of full thickness tear. We used 5 mm twin fix double loaded suture anchor e ultrabraid in the repair of rotator cuff.…”

Section: Discussionmentioning

confidence: 97%