The effectiveness of continuous passive motion on range of motion, pain and muscle strength following rotator cuff repair: a systematic review

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.

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No difference between tenotomy vs tenodesis for the long head of the biceps tendinopathy in rotator cuff repair: a systematic review

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine ◽

10.1136/jisakos-2016-000081 ◽

2017 ◽

Vol 2 (2) ◽

pp. 89-96

Author(s):

Nicola Maffulli ◽

Rocco Papalia ◽

Guglielmo Torre ◽

Sebastiano Vasta ◽

Giuseppe Papalia ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Long Head ◽

Cuff Repair

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Prevention and Management of Stiffness After Arthroscopic Rotator Cuff Repair: Systematic Review and Implications for Rotator Cuff Healing

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2011.01.013 ◽

2011 ◽

Vol 27 (6) ◽

pp. 842-848 ◽

Cited By ~ 79

Author(s):

Patrick J. Denard ◽

Alexandre Lädermann ◽

Stephen S. Burkhart

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

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Does the Literature Support Double-Row Suture Anchor Fixation for Arthroscopic Rotator Cuff Repair? A Systematic Review Comparing Double-Row and Single-Row Suture Anchor Configuration

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2009.02.005 ◽

2009 ◽

Vol 25 (11) ◽

pp. 1319-1328 ◽

Cited By ~ 71

Author(s):

Shane J. Nho ◽

Mark A. Slabaugh ◽

Shane T. Seroyer ◽

Robert C. Grumet ◽

Joseph B. Wilson ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Suture Anchor ◽

Double Row ◽

Single Row ◽

Arthroscopic Rotator Cuff ◽

Suture Anchor Fixation ◽

Cuff Repair ◽

Anchor Fixation

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Return to Work After Primary Rotator Cuff Repair: A Systematic Review and Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/0363546520975426 ◽

2021 ◽

pp. 036354652097542

Author(s):

Eric D. Haunschild ◽

Ron Gilat ◽

Ophelie Lavoie-Gagne ◽

Michael C. Fu ◽

Tracy Tauro ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Return To Work ◽

Rotator Cuff Repair ◽

Meta Analysis ◽

Work Outcomes ◽

Workers Compensation ◽

Work Intensity ◽

Rates Of Return ◽

Cuff Repair

Background: Rotator cuff tears are a prevalent pathology in injured workers, causing significant economic ramifications and time away from work. To date, published articles on work outcomes after rotator cuff repair have not been cumulatively assessed and analyzed. Purpose: To systematically review reports on return to work after rotator cuff repair and perform a meta-analysis on factors associated with improved work outcomes. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review of return-to-work investigations was performed using PubMed, Embase, and the Cochrane Database of Systematic Reviews in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Individual studies reporting rates of return to previous work with level of evidence 1 to 4 were independently screened by 2 authors for inclusion, and study quality was assessed using the Methodologic Index for Non-randomized Studies and Newcastle-Ottawa Scale. Work outcome data were synthesized and analyzed using random effects modeling to identify differences in rates of return to previous work as a function of operative technique, work intensity, and workers’ compensation status. Results: Thirteen retrospective investigations comprising 1224 patients who underwent rotator cuff repair met inclusion criteria for this investigation. Across all investigations, a weighted average of 62.3% of patients returned to previous level of work at 8.15 ± 2.7 months (mean ± SD) after surgery. Based on random effects modeling, higher rates of return to previous work were identified with decreasing work intensity ( P < .001), while rates were similar between open and arthroscopic repair technique ( P = .418) and between workers’ compensation and non–workers’ compensation cohorts ( P = .089). All shoulder pain and functional outcome assessments demonstrated significant improvements at final follow-up when compared with baseline across all investigations. Conclusion: The majority of injured workers undergoing rotator cuff repair return to previous work at approximately 8 months after surgery. Despite this, >35% of patients are unable to return to their previous work level after their repair procedure. Similar rates of return to work can be anticipated regardless of workers’ compensation status and operative technique, while patients in occupations with higher physical intensity experience inferior work outcomes.

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