Postoperative Rehabilitation Following Rotator Cuff Repair: General Principles

2019 ◽  
pp. 481-492
Author(s):  
Tyler Spiering ◽  
Corey Snyder ◽  
Michael T. Freehill
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Postoperative Rehabilitation ◽  
Cuff Repair

scholarly journals The Effects of a Standard Postoperative Rehabilitation Protocol for Arthroscopic Rotator Cuff Repair on Pain, Function, and Health Perception

Joints ◽  
2018 ◽  
Vol 06 (03) ◽  
pp. 145-152 ◽  
Author(s):  
Roberta Monesi ◽  
Maria Benedetti ◽  
Alessandro Zati ◽  
Daniela Vigna ◽  
Domenico Romanello ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Case Series ◽  
Arthroscopic Rotator Cuff Repair ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocol ◽  
Constant Murley Score ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Purpose There is still conflicting evidence to support postoperative rehabilitation protocols using immobilization following rotator cuff repair over early motion. The objective of the study was to evaluate the evolution of pain, shoulder function, and patients' perception of their health status up to 1 year after cuff rotator repair and a standard postoperative rehabilitation protocol consisting of 4 weeks of immobilization followed by a 2-week assisted controlled rehabilitation. Methods Descriptive, longitudinal, uncontrolled case-series study was performed on 49 patients who underwent arthroscopic rotator cuff repair following traumatic or degenerative lesions. VAS scale for pain, Constant–Murley score for function, and SF-12 score for quality of life were used as outcome measures and were administered before the rehabilitation treatment, at the end of the 2-week rehabilitation, 3 months, and 1 year after surgery. Results VAS pain score decreased significantly along the follow-up reaching almost a nil value after 1 year (0.2). Function as measured by Constant–Murley score had a significant improvement during follow-up, reaching a mean value of 84.6. The short form (SF)-12 score increased over time reaching 46.3 for the physical and 43.8 for the psychological dimension, respectively, at 1 year. Conclusion The present study confirmed an excellent outcome at 1 year after rotator cuff repair using a traditional 4-week immobilization followed by a 2-week rehabilitation protocol without evidence of tendon un-healing or re-tearing. Level of Evidence This is a level IV, therapeutic case series.

scholarly journals Postoperative Rehabilitation After Rotator Cuff Repair

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668477 ◽  
Author(s):  
Scott Mollison ◽  
Jason J. Shin ◽  
Alexander Glogau ◽  
R. Cole Beavis
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Demographic Data ◽  
Average Response Rate ◽  
Postoperative Rehabilitation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Rehabilitation Protocols ◽  
Cuff Repair

Background: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. Hypothesis/Purpose: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA). We hypothesized that there will exist a high degree of variability among rehabilitation protocols. We also predict that surgeons will be prescribing accelerated rehabilitation. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A 29-question survey in English language was sent to all 3106 associate and active members of the AOSSM and the AANA. The questionnaire consisted of 4 categories: standard postoperative protocol, modification to postoperative rehabilitation, operative technique, and surgeon demographic data. Via email, the survey was sent on September 4, 2013. Results: The average response rate per question was 22.7%, representing an average of 704 total responses per question. The most common immobilization device was an abduction pillow sling with the arm in neutral or slight internal rotation (70%). Surgeons tended toward later unrestricted passive shoulder range of motion at 6 to 7 weeks (35%). Strengthening exercises were most commonly prescribed between 6 weeks and 3 months (56%). Unrestricted return to activities was most commonly allowed at 5 to 6 months. The majority of the respondents agreed that they would change their protocol based on differences expressed in this survey. Conclusion: There is tremendous variability in postoperative rehabilitation protocols after ARCR. Five of 10 questions regarding standard rehabilitation reached a consensus statement. Contrary to our hypothesis, there was a trend toward later mobilization.

Postoperative Rehabilitation of Rotator Cuff Repair: A Systematic Review

2021 ◽  
Vol 29 (2) ◽  
pp. 119-129
Author(s):  
Steven Matlak ◽  
Albert Andrews ◽  
Austin Looney ◽  
Kenneth B. Tepper
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Postoperative Rehabilitation ◽  
Cuff Repair

scholarly journals Conservative Rehabilitation Provides Superior Clinical Results Compared to Early Aggressive Rehabilitation for Rotator Cuff Repair: A Retrospective Comparative Study

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 402 ◽  
Author(s):  
Umile Giuseppe Longo ◽  
Giacomo Rizzello ◽  
Stefano Petrillo ◽  
Mattia Loppini ◽  
Nicola Maffulli ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Clinical Results ◽  
Postoperative Rehabilitation ◽  
Forward Flexion ◽  
Surgery Group ◽  
Significant Difference ◽  
Group A ◽  
Cuff Repair

Background and objectives: To compare the long term clinical outcomes, range of motion (ROM) and strength of two different postoperative rehabilitation protocols after arthroscopic rotator cuff repair (RCR) for full-thickness rotator cuff (RC) tears. Materials and Methods: Patients undergoing RCR were divided into two groups. In 51 patients (56 shoulders), rehabilitation was performed without passive external rotation, anterior elevation ROM, and active pendulum exercises in the first 2 weeks after surgery (Group A). In 49 patients (50 shoulders) aggressive rehabilitation was implemented, with early free passive external rotation, anterior elevation ROM, and active pendulum exercises were allowed from the day after surgery (Group A). Results: No statistically significant differences were found in clinical scores, muscle strength, passive forward flexion, passive and active internal/external rotation between the two groups. However, the mean active forward flexion was 167.3° ± 26° (range 90–180°) in group A and 156.5° ± 30.5° (range 90–180°) in group B (p = 0.04). Conclusions: A statistically significant difference between the 2 groups was found in active forward flexion ROM, which was better in patients of group A.

scholarly journals Physical Therapist Management Following Rotator Cuff Repair for a Patient With Postpolio Syndrome

2007 ◽  
Vol 87 (2) ◽  
pp. 179-192 ◽  
Author(s):  
Mary Carlson ◽  
Tana Hadlock
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Postoperative Rehabilitation ◽  
Postpolio Syndrome ◽  
First Case ◽  
Cuff Repair ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Background and PurposePostpoliomyelitis sequelae, such as gait instability and progressive weakness, predispose people with postpolio syndrome to secondary disabilities. With aging, people who depend on their upper extremities to accommodate lower-extremity deficits may anticipate overuse injuries. The purpose of this case report is to describe the use of mobilization and exercise in postoperative rehabilitation of rotator cuff surgery on a patient with postpolio syndrome.Case DescriptionA 48-year-old woman with postpolio syndrome had rotator cuff surgical repair followed by physical therapy intervention. Maitland mobilization and mild functional exercises were chosen to avoid triggering fatigue.OutcomesMeasurements taken preoperatively, before and after physical therapy intervention, and 2 years after intervention showed return to independent status with excellent retention.DiscussionNo fatigue or overuse weakness was encountered. This is the first case report to document physical therapy following rotator cuff repair in a patient with postpolio syndrome.

scholarly journals In Vivo Vascularity Alterations in Repaired Rotator Cuffs Determined by Contrast-Enhanced Ultrasound

2011 ◽  
Vol 39 (12) ◽  
pp. 2640-2646 ◽  
Author(s):  
Tadanao Funakoshi ◽  
Norimasa Iwasaki ◽  
Tamotsu Kamishima ◽  
Mutsumi Nishida ◽  
Yoichi Ito ◽  
...  
Keyword(s):  
Blood Flow ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Surrounding Tissue ◽  
Ultrasound Images ◽  
Contrast Enhanced Ultrasound ◽  
Postoperative Rehabilitation ◽  
Contrast Enhanced ◽  
Cuff Repair

Background: The alterations in blood flow after rotator cuff repair remain unclear. Visualization of vascular patterns could clarify basic and clinical investigations. Purpose: To assess longitudinal blood flow inside the repaired cuff and the surrounding tissue after rotator cuff repair, using contrast-enhanced ultrasonography. Study Design: Descriptive laboratory study. Methods: Fifteen patients (7 men and 8 women; mean age, 65.0 ± 9.8 years) consented to participate. The patients underwent an ultrasound scan before and 1, 2, and 3 months after surgery. Enhanced ultrasound images were recorded for 1 minute after intravenous injection of contrast reagent. Four regions of interest inside the cuff and 2 regions in the anchor hole and subacromial bursa were superimposed on the obtained images. Calculated areas under the time-intensity curves were expressed in acoustic units (AU). Results: We found area-dependent differences in patterns of alteration and magnitude of blood flow inside the repaired cuff and peritendinous tissues. Vascularity in the articular distal and bursal distal region of the repaired cuff at 1 month postoperatively increased significantly compared with that at the preoperative baseline (76 vs 5 AU, P = .0037; 92 vs 7 AU, P = .043). The vascularity peaked at 1 month after surgery in the bursal area within the cuff but at 2 months in the articular area. The vascularity in the articular proximal region of the repaired cuff was significantly lower than that in the bursal proximal ( P = .0046), bursal distal ( P = .0183), and articular distal regions ( P = .0163) 1 month after surgery. Conclusion: Enhancement patterns in intratendinous tissue increased at 1 or 2 months postoperatively and decreased at 3 months. We found area-dependent differences in enhancement patterns inside the repaired cuff and peritendinous tissue. Clinical Relevance: Visualization of vascularization using contrast-enhanced ultrasound could help in deciding on an appropriate repair technique or on the form of postoperative rehabilitation after rotator cuff repair.

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