Early Versus Delayed Mobilization for Arthroscopic Rotator Cuff Repair (small to Large Sized Tear): a Meta-analysis of Randomized Controlled Trials

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2023 Dec 4

PMID 38049792

Authors

Ching-Wei Hu

Sung Huang Laurent Tsai

Chien-Hao Chen

Hao-Che Tang

Chun-Yi Su

Eric H Tischler

Yi-Chiang Yang

Yi-Sheng Chan

Chih-Hao Chiu

Alvin Chao Yu Chen

Affiliations

Soon will be listed here.

Abstract

Background: The timing to start passive or active range of motion (ROM) after arthroscopic rotator cuff repair remains unclear. This systematic review and meta-analysis evaluated early versus delayed passive and active ROM protocols following arthroscopic rotator cuff repair. The aim of this study is to systematically review the literature on the outcomes of early active/passive versus delayed active/passive postoperative arthroscopic rotator cuff repair rehabilitation protocols.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) published up to April 2022 comparing early motion (EM) versus delayed motion (DM) rehabilitation protocols after arthroscopic rotator cuff repair for partial and full-thickness tear was conducted. The primary outcome was range of motion (anterior flexion, external rotation, internal rotation, abduction) and the secondary outcomes were Constant-Murley score (CMS), Simple Shoulder Test Score (SST score) and Visual Analogue Scale (VAS).

Results: Thirteen RCTs with 1,082 patients were included in this study (7 RCTs for early passive motion (EPM) vs. delayed passive motion (DPM) and 7 RCTs for early active motion (EAM) vs. delayed active motion (DAM). Anterior flexion (1.40, 95% confidence interval (CI), 0.55-2.25) and abduction (2.73, 95%CI, 0.74-4.71) were higher in the EPM group compared to DPM. Similarly, EAM showed superiority in anterior flexion (1.57, 95%CI, 0.62-2.52) and external rotation (1.59, 95%CI, 0.36-2.82), compared to DAM. There was no difference between EPM and DPM for external rotation, retear rate, CMS and SST scores. There was no difference between EAM and DAM for retear rate, abduction, CMS and VAS.

Conclusion: EAM and EPM were both associated with superior ROM compared to the DAM and DPM protocols. EAM and EPM were both safe and beneficial to improve ROM after arthroscopic surgery for the patients with small to large sized tears.

Citing Articles

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Guo J, Que M, Guo J, Liu Z, Che Y J Orthop. 2025; 67:177-182.

PMID: 40051640 PMC: 11880330. DOI: 10.1016/j.jor.2025.02.006.

Maximizing hand function following zone II flexor tendon repair: A systematic review and meta-analysis of rehabilitation strategies.

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Correction: Early versus delayed mobilization for arthroscopic rotator cuff repair (small to large sized tear): a meta-analysis of randomized controlled trials.

Hu C, Tsai S, Chen C, Tang H, Su C, Tischler E BMC Musculoskelet Disord. 2024; 25(1):974.

PMID: 39604927 PMC: 11603796. DOI: 10.1186/s12891-024-08079-5.

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