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Systematic review of postoperative therapy protocols used in studies assessing arthroscopic rotator cuff repair: has there been a trend towards accelerated rehabilitation?

Authors: P Wright, T Donaldson, L Funk

References: European Shoulder & Elbow Society Meeting, Lyon - 13-16 September 2011

Purpose
Whilst there have been many developments in the arthroscopic techniques employed to treat tears of the rotator cuff, little has been done to 
determine whether postoperative rehabilitation has undergone a similar evolution.
Material and Methods
A literature search was performed using the Pubmed bibliographic database for studies of arthroscopic rotator cuff repair between 1996 and 2011. 
Studies were divided into two groups ; those published between 1996 and 2008 and between 2009 and 2011. Details of the rehabilitation protocol 
were recorded including duration and type of sling, initiation of passive range of movement, initiation of active range of movement and initiation of 
strengthening exercises.
Results
55 papers were included. The studies included varied widely in all aspects of the therapy programme used. Those studies published during the later 
time period there was a trend towards a longer period of immobilisation in a sling and the delay of strengthening exercises until the twelfth 
postoperative period or beyond. The initiation of passive and active range of movement exercises was similar in both groups.
Conclusion
Despite ongoing improvements in surgical technique to provide increasingly secure fixation of the rotator cuff there has not been a trend towards 
earlier mobilisation in the rehabilitation protocols published in the orthopaedic literature.


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