Effectiveness of abduction brace versus simple sling rehabilitation following rotator cuff repair: systematic review and meta-analyses.

Abstract

To date, no conclusions have been reached regarding the type of brace worn after arthroscopic rotator cuff repair. To this end, a systematic review and meta-analysis of randomized controlled trials was conducted. According to the updated guidelines of the preferred reporting items of systematic review and meta-analysis (PRISMA), all related literature in PubMed, Embase, and Cochrane Central Register of Controlled Trials (Central), from their establishment to March 1, 2022, were searched systematically. Outcome measures included the Constant score, Western Ontario Rotator Cuff (WORC) index, visual analog scale (VAS) score, shoulder joint range of motion (ROM), and failure events of rotator cuff healing. The Cochrane risk-of-bias tool was used to evaluate the quality of randomized controlled trials (RCT). Two independent reviewers (Chen, Wu) reviewed 275 articles, of which only five met the inclusion criteria, and four were included in the meta-analysis, with a total of 302 patients. The overall risk of bias was high in two RCTs, unclear in one, and low in two. Considering the clinical outcomes, the Constant score (P = 0.08 MD, 3.06; 95% confidence interval [CI], -0.42 to 6.53), WORC (P = 0.23; MD, 3.32; 95%CI,-2.15 to 8.79) , visual analog scale (VAS) score (P=0.09; MD -1.27; 95%CI, -2.75 to 0.21), ROM (P = 0.1; MD, 4.75; 95%CI, -0.98 to 10.48), and failure events of rotator cuff healing (P = 0.78; odds ratio[OR], 0.86; 95%CI, 0.32 to 2.37) did not significantly differ between the abduction brace and simple sling after arthroscopic rotator cuff repair. The findings of this systematic review and meta-analysis suggest that wearing abduction braces after rotator cuff repair neither improved the Constant score , VAS, and WORC scores, and ROM of the shoulder joint, nor did it reduce the risk of retearing . Therefore, a simple sling may be a better option in terms of cost-effectiveness. It is expected that studies with larger and more homogeneous samples will help verify our results.