Is It Necessary to Use a Sling or Abduction Pillow Sling After Superior Rotator Cuff Repair? A Preliminary Report

Overview

Journal Turk J Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2025 Mar 3

PMID 40028412

Authors

Ismail Murad Pepe

Yavuz Sahbat

Emre Calisal

Selcuk Yilmaz

Ismet Asli Topcuoglu

Ayca Araci

Yildiz Erdoganoglu

Affiliations

Soon will be listed here.

Abstract

Objectives: The study aimed to evaluate the effects of the use of a shoulder sling, shoulder sling with a pillow, or not using a sling on the shoulder functional score and pain levels following arthroscopic rotator cuff tear repair.

Patients And Methods: This randomized prospective study was performed with 90 patients (49 males, 41 females; mean age: 56.2±12.2 year; range, 33 to 77 years) with a small-to-mid, full-thickness rotator cuff tear between July 2020 and October 2022. All patients underwent arthroscopic double-row repair. The nonsling group wore no sling, the sling group wore a sling, and the abduction pillow sling group wore a sling with an abduction pillow. The same rehabilitation program was performed. The Visual Analog Scale (VAS) score, Constant-Murley scores, and degrees of flexion and abduction were recorded preoperatively, on the 15 and 45 days, and at three months, six months, and one year.

Results: On the 15 postoperative day, the VAS score was found to be significantly lower in the nonsling group. On the 45 day, the Constant-Murley score was found to be significantly higher in the abduction pillow sling group. There was no significant difference between the groups regarding the Constant-Murley scores at three weeks, six months, and one year. The shoulder forward flexion angle was significantly lower in the nonsling group on the 45 day. There was no significant difference between the three groups in respect of the shoulder forward flexion at three months, six months, and one year.

Conclusion: No difference was determined between the groups at the six-month and one-year functional results. Not using a sling bandage can be recommended by reducing pain in the early postoperative period.

References

Klintberg I, Gunnarsson A, Svantesson U, Styf J, Karlsson J . Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up. Clin Rehabil. 2009; 23(7):622-38. DOI: 10.1177/0269215509102952. View

Acevedo D, Paxton E, Williams G, Abboud J . A Survey of Expert Opinion Regarding Rotator Cuff Repair. J Bone Joint Surg Am. 2014; 96(14):e123. DOI: 10.2106/JBJS.M.00399. View

Mazzocca A, Arciero R, Shea K, Apostolakos J, Solovyova O, Gomlinski G . The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair. Arthroscopy. 2017; 33(6):1138-1148. DOI: 10.1016/j.arthro.2016.10.017. View

Saltzman B, Zuke W, Go B, Mascarenhas R, Verma N, Cole B . Does early motion lead to a higher failure rate or better outcomes after arthroscopic rotator cuff repair? A systematic review of overlapping meta-analyses. J Shoulder Elbow Surg. 2017; 26(9):1681-1691. DOI: 10.1016/j.jse.2017.04.004. View

Giesen T, Calcagni M, Elliot D . Primary Flexor Tendon Repair with Early Active Motion: Experience in Europe. Hand Clin. 2017; 33(3):465-472. DOI: 10.1016/j.hcl.2017.03.001. View

Aksahin E, Aktekin C, Kocadal O, Duran S, Gunay C, Kaya D . Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella. Knee Surg Sports Traumatol Arthrosc. 2016; 25(10):3038-3045. DOI: 10.1007/s00167-016-4083-4. View

Keener J, Galatz L, Stobbs-Cucchi G, Patton R, Yamaguchi K . Rehabilitation following arthroscopic rotator cuff repair: a prospective randomized trial of immobilization compared with early motion. J Bone Joint Surg Am. 2014; 96(1):11-9. DOI: 10.2106/JBJS.M.00034. View

Pandey V, Madi S, Maddukuri S, Acharya K, Karegowda L, Willems W . Does application of abduction brace after arthroscopic rotator cuff repair improve blood flow around posterosuperior rotator cuff and repair site, affecting pain levels and clinical and structural outcomes? A pilot randomized controlled trial. JSES Int. 2020; 4(4):848-859. PMC: 7738580. DOI: 10.1016/j.jseint.2020.07.021. View

Sgroi T, Cilenti M . Rotator cuff repair: post-operative rehabilitation concepts. Curr Rev Musculoskelet Med. 2018; 11(1):86-91. PMC: 5825343. DOI: 10.1007/s12178-018-9462-7. View

10.

Denard P, Ladermann A, Burkhart S . Prevention and management of stiffness after arthroscopic rotator cuff repair: systematic review and implications for rotator cuff healing. Arthroscopy. 2011; 27(6):842-8. DOI: 10.1016/j.arthro.2011.01.013. View

11.

Houck D, Kraeutler M, Schuette H, McCarty E, Bravman J . Early Versus Delayed Motion After Rotator Cuff Repair: A Systematic Review of Overlapping Meta-analyses. Am J Sports Med. 2017; 45(12):2911-2915. DOI: 10.1177/0363546517692543. View

12.

Chung S, Huong C, Kim S, Oh J . Shoulder stiffness after rotator cuff repair: risk factors and influence on outcome. Arthroscopy. 2013; 29(2):290-300. DOI: 10.1016/j.arthro.2012.08.023. View

13.

Nikolaidou O, Migkou S, Karampalis C . Rehabilitation after Rotator Cuff Repair. Open Orthop J. 2017; 11:154-162. PMC: 5366376. DOI: 10.2174/1874325001711010154. View

14.

Freehill M, Murray I, Calvo E, Ladermann A, Srikumaran U . Shoulder Surgery Postoperative Immobilization: An International Survey of Shoulder Surgeons. Biology (Basel). 2023; 12(2). PMC: 9953745. DOI: 10.3390/biology12020291. View

15.

Rokito A, Zuckerman J, Gallagher M, Cuomo F . Strength after surgical repair of the rotator cuff. J Shoulder Elbow Surg. 1996; 5(1):12-7. DOI: 10.1016/s1058-2746(96)80025-5. View

16.

Pepe M, Calisal E, Kocadal O, Bicer E, Taskin S, Aktekin C . The Role of Surgical Closure Position in Total Knee Arthroplasty: Flexion versus Extension-A Randomized Prospective Study. J Knee Surg. 2018; 32(7):624-629. DOI: 10.1055/s-0038-1666865. View

17.

Brislin K, Field L, Savoie 3rd F . Complications after arthroscopic rotator cuff repair. Arthroscopy. 2007; 23(2):124-8. DOI: 10.1016/j.arthro.2006.09.001. View

18.

Namdari S, Green A . Range of motion limitation after rotator cuff repair. J Shoulder Elbow Surg. 2009; 19(2):290-6. DOI: 10.1016/j.jse.2009.07.009. View

19.

Valkering K, Aufwerber S, Ranuccio F, Lunini E, Edman G, Ackermann P . Functional weight-bearing mobilization after Achilles tendon rupture enhances early healing response: a single-blinded randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2016; 25(6):1807-1816. PMC: 5487693. DOI: 10.1007/s00167-016-4270-3. View

20.

Hawthorne J, Carpenter E, Lam P, Murrell G . Effects of Abduction Pillows on Rotator Cuff Repair: A Biomechanical Analysis. HSS J. 2018; 14(2):114-122. PMC: 6031537. DOI: 10.1007/s11420-017-9592-2. View