Silveira, A.
Early Mobilization Following Arthroscopic Rotator Cuff Repair
Silveira, A., Sheps, D., Beaupre, L., Styles-Tripp, F., Balyk, R., Lalani, A., Glasgow, R., Bergman, J., Bouliane, M.
Current evidence regarding the optimal period of immobilization after Rotator Cuff (RC) repair is contradictory. Early mobilization may allow faster recovery without negatively affecting patient outcomes. This randomized clinical trial (RCT) compared the impact of early mobilization to standard 6-weeks postoperative immobilization post Arthroscopic Rotator Cuff Repair (ARCR) over the 24-months postoperative. The overall goal of this presentation is to show the results of this RCT and how it impacted current practice.
206 patients with full-thickness RC tear undergoing an ARCR were randomized following a preoperative assessment of shoulder pain, Range of Motion (ROM), strength and health related quality of life (HRQL) to either early mobilization (n=103; self-weaned from sling and performed painfree active ROM during the first 6 weeks) or standard immobilization (n=103; wore a sling for 6 weeks with no active ROM). Shoulder ROM, pain and HRQL were re-assessed at 6-weeks, 3-, 6- ,12- and 24-months postoperatively by a blinded assessor. At 6- 12-, and 24-months, strength was re-assessed. At 12-months, ultrasound verified RC integrity.
The groups were similar preoperatively (p>0.12). The average age of all subjects was 55.9 (minimum 26, maximum 79) years and 131 (64%) were males. 171 (83%) patients were followed to 24- months. Overall, there were no group differences in ROM (p>0.08), HRQL (p>0.2), pain (p>0.06), or strength (p=0.35). 52 (25%) subjects (24-EM and 28-SR) had a full thickness tear at 12-month postoperative ultrasound testing (p>0.8).
Early mobilization did not show significant clinical benefits, but there was no compromise of postoperative strength or HRQL. Repair integrity was similar at 12-months postoperative between groups. Consideration should be given to allow painfree active ROM within the first 6 weeks following an ARCR.