Evidence-Based Hand and Upper Extremity Surgery

Abstract

Stiffness is a concern after rotator cuff surgery, but early exercises risk disrupting tendon sutures. A prospective randomized trial of 105 consecutive patients undergoing arthroscopic suturing of small to mediumsize full-thickness rotator cuff defects was undertaken comparing early (postoperative day 1) passive motion exercises 3 to 4 times per day with delayed passive motion following brace removal (4 wk for tears 1 cm and 5 weeks for tears of 1–3 cm). Both groups began strengthening at 9 to 12 weeks, and unrestricted activities were allowed at 6 months. There were no significant differences in demographics between groups. At 12 months, there were improvements in both groups with no significant differences in pain, range of motion (ROM) and functional outcomes (Constant Score, Simple Shoulder Test [SST], and American Shoulder and Elbow Surgeons [ASES] scores). Ultrasound (3–6 mo) and computed tomography (CT) or magnetic resonance imaging (MRI) (12 mo) revealed healing in 49/56 patients in the early motion group and 40/49 in the delayed motion group.