Passive motion vs. immobilization after rotator cuff repair
Postoperative joint stiffness is still a major complication of both open as well as arthroscopic rotator cuff repair procedures. Although it is often suggested that early passive motion (EPM) may have beneficial effects on pain and functional limitations, there is no consensus on this subject yet.
This meta-analysis included five level II studies – on top of that, one level IV study was included for qualitative review. Of the level II studies, only four provided sufficient information regarding postoperative ROM; all five were included to analyze retear rates after rotator cuff surgery.
As a result of EPM, improved forward flexion and external rotation were present at 3 months postoperatively. A positive effect on forward flexion was present up to 12 months after surgery, but diminished in time: at 12 months, the difference was only 5 degrees in favour of EPM. No significant differences in retear rates were present. However, a larger number of studies included for analysis might have led to relevant increases in retears after surgery.
> From: Riboh et al., Arthroscopy 30 (2014) 997-1005. All rights reserved to the Arthroscopy Association of North America. Click here for the Pubmed summary.