Abstract
This update is based on the scientific and investigational activities in the specialty of sports medicine from September 2014 to August 2015. It includes a review of pertinent research and articles published in the three premier journals of our specialty, namely, The Journal of Bone & Joint Surgery, The American Journal of Sports Medicine , and Arthroscopy: The Journal of Arthroscopic and Related Surgery. ### Rotator Cuff #### Degenerative Rotator Cuff Tear History The natural history of degenerative rotator cuff tear progression is still being elucidated. There are many studies that show the prevalence of asymptomatic rotator cuff tears, but few exist that evaluate the long-term prospective patient history. Keener et al. attempted to characterize the amount of rotator cuff tear enlargement and progression of symptoms with initial asymptomatic tears. They studied asymptomatic rotator cuff tears in patients who had a symptomatic contralateral rotator cuff tear. In their study, they showed that tears enlarged in almost one-half of the patients over a median of 3 years and those patients who experienced tear enlargement tended to have an onset of new pain. Progressive degenerative changes within the supraspinatus and infraspinatus muscles were associated with tear enlargement compared with the control group. These findings show that many of these tears may progress and may become symptomatic1. #### Therapy After Rotator Cuff Repair Although therapy after rotator cuff repair is universal, the optimal timing of rehabilitation initiation is still unknown. Studies have suggested that outcome scores are better with early passive motion (<6 weeks after the surgical procedure) than with delayed motion (≥6 weeks), but the association of rehabilitation schedule and retear rate is not fully understood. In a systematic review and meta-analysis, Kluczynski et al. found that, in randomized controlled studies, there was not a significant difference between the 2 rehabilitation schedules with respect to retear rates. With analysis of those studies that did not …
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