Early motion shows results comparable to immobilization after arthroscopic rotator cuff repair
In a 30-month follow-up of young patients who underwent arthroscopic rotator cuff repair, researchers found no significant differences in shoulder function between those who had early passive range of motion and patients who were immobilized.
“There is no apparent advantage or disadvantage of early passive range of motion compared with immobilization with regard to healing or functional outcome,” Jay D. Keener, MD, and colleagues from Washington University wrote in their abstract.
The investigators studied 124 patients younger than 65 years who underwent arthroscopic repair of full-thickness rotator cuff tears and were randomized to either an early range of motion rehabilitation process or to an immobilization group that had range of motion delayed for 6 weeks. The investigators evaluated the patients using the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, relative Constant score and strength measurements. There were 114 patients available for final follow-up.
At 3 months postoperatively, the immobilization group had significantly better mean active range of motion into elevation and external rotation compared with the early motion cohort. “After 3 months, there were no significant differences in VAS pain score, active range-of-motion values, shoulder strength measures, or any of the functional scales between the groups at the time of the 6-month, 12-month, or final follow-up evaluation,” wrote Keener and colleagues wrote in their study.
Although the investigators’ research did not study patient satisfaction, “Immobilization did not appear to lead to greater risks of shoulder stiffness,” they wrote. There was also no difference in terms of tendon healing between groups.
“Either early passive motion or a period of early immobilization is equally safe and effective after surgical rotator cuff repair in this cohort,” the researchers wrote.
Keener J. J Bone Joint Surg Am. 2014;doi: 10.2106/JBJS.M.00034.Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the 36 months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work.