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Early motion versus immobilization for arthroscopic repair in the treatment of large size rotator cuff tears

Background: To compare the clinical effect between early motion and immobilization after arthroscopic rotator cuff repair.

Methods: From January 2013 to July 2016, a total of 132 patients underwent arthroscopic repair of a large size rotator cuff tear, the patients were randomly divided into observation group (66 cases) and control group (66 cases). Postoperatively, the observation group received early motion and the control group received immobilization, then the clinical outcomes in two groups were comparatively analysed, including the range of motion, Visual Analogue Scale (VAS) score, muscle strength, University of California-Los Angeles (UCLA) shoulder score and Constant shoulder score, and re-tear rates, and these parameters were performed and assessed at 3, 6, and 12 months after arthroscopic rotator cuff repair.

Results: At 12 months after arthroscopic rotator cuff repair, the two groups showed no significant difference in the range of motion (P>0.05). Six patients in the observation group and four patients in the control group appeared re-tear, the differences were not statistically significant (P>0.05). However, the incidence of stiffness in the control group was significantly higher than that in the observation group (36.36% vs. 15.15%, P<0.05). The two groups both obtained significantly better functional score than that before surgery (P<0.05). However, there was no significant difference between the two groups in VAS score, muscle strength, UCLA shoulder score and Constant shoulder score at the final follow-up period (P>0.05).

Conclusion: Compared with immobilization, early motion can obtain similar functional outcomes in the later stage and reduce incidence of stiffness, which should be recommended in large size rotator cuff tear after arthroscopy repair.

Author(s): Jian-lin Zhang, Dong-yu Bai, Jiang-wei Yang, Yan-jun Luan, Cheng-jin Zhao