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Effect of Two Rehabilitation Protocols on Range of Motion and Healing Rates After Arthroscopic Rotator Cuff Repair: Aggressive Versus Limited Early Passive Exercises

Title
Effect of Two Rehabilitation Protocols on Range of Motion and Healing Rates After Arthroscopic Rotator Cuff Repair: Aggressive Versus Limited Early Passive Exercises
Author
이봉근
Keywords
DOUBLE-ROW; SINGLE-ROW; SUPRASPINATUS TENDON; SUTURE ANCHORS; INTEGRITY; TEARS; FIXATION; STRENGTH; TRIAL
Issue Date
2012-01
Publisher
W B SAUNDERS CO-ELSEVIER INC, 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
Citation
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 권: 28, 호: 1, 페이지: 34-42
Abstract
Purpose: To compare range of motion and healing rates between 2 different rehabilitation protocols after arthroscopic single-row repair for full-thickness rotator cuff tear. Methods: Sixty-four shoulders available for postoperative magnetic resonance imaging (MRI) evaluation after arthroscopic rotator cuff repair were enrolled in this study. Aggressive early passive rehabilitation (manual therapy [2 times per day] and unlimited self-passive stretching exercise) was performed in 30 shoulders (group A) and limited early passive rehabilitation (limited continuous passive motion exercise and limited self-passive exercise) in 34 shoulders (group B). A postoperative MRI scan was performed at a mean of 7.6 months (range, 6 to 12 months) after surgery. Results: Regarding range of motion, group A improved more rapidly in forward flexion, external rotation at the side, internal and external rotation at 90 degrees of abduction, and abduction than group B until 3 months postoperatively with significant differences. However, there were no statistically significant differences between the 2 groups at 1-year follow-up (P = .827 for forward flexion, P = .132 for external rotation at the side, P = .661 for external rotation at 90 degrees of abduction, and P = .252 for abduction), except in internal rotation at 90 degrees of abduction (P = .021). In assessing the repair integrity with postoperative MRI scans, 7 of 30 cases (23.3%) in group A and 3 of 34 cases (8.8%) in group B had retears, but the difference was not statistically significant (P = .106). Conclusions: Pain, range of motion, muscle strength, and function all significantly improved after arthroscopic rotator cuff repair, regardless of early postoperative rehabilitation protocols. However, aggressive early motion may increase the possibility of anatomic failure at the repaired cuff. A gentle rehabilitation protocol with limits in range of motion and exercise times after arthroscopic rotator cuff repair would be better for tendon healing without taking any substantial risks. Level of Evidence: Level II, randomized controlled trial.
URI
http://www.sciencedirect.com/science/article/pii/S0749806311006761?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb
ISSN
0749-8063
DOI
10.1016/j.arthro.2011.07.012
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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