Conservative versus accelerated rehabilitation after rotator cuff repair: a systematic review and meta-analysis

BMC Musculoskeletal Disorders

Ara Nazarian¹  Joseph DeAngelis¹  Vincenzo Denaro²  Vincenzo Candela²  Filippo Migliorini²  Umile Giuseppe Longo²  Laura Risi Ambrogioni²  Alessandra Berton²  Emiliano Schena³  Arianna Carnevale³ 

[1] Center for Advanced Orthopaedic Studies, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128, Rome, Trigoria, Italy;Research Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128, Rome, Trigoria, Italy;

关键词: Conservative;    Accelerated;    Rehabilitation;    Protocol;    Rotator cuff;    Rotator cuff repair;   

DOI  :  10.1186/s12891-021-04397-0

来源: Springer

【 摘 要 】

BackgroundThe purpose of this systematic review and meta-analysis is to compare the conservative and accelerated rehabilitation protocols in patients who underwent arthroscopic rotator cuff repair in terms of clinical outcomes and range of motions at 3, 6, 12, and 24-month follow-up.MethodsAccording to PRISMA guidelines, a systematic review of the literature was performed. For each included article, the following data has been extracted: authors, year, study design, level of evidence, demographic characteristics, follow-up, clinical outcomes, range of motions, and retear events. A meta-analysis was performed to compare accelerated versus conservative rehabilitation protocols after arthroscopic rotator cuff repair. The retear rate, postoperative Constant-Murley score and range of motions at 3, 6, 12, and 24 months of follow-up were the outcomes measured.ResultsThe search strategy yielded 16 level I-II clinical studies. A total of 1424 patients, with 732 patients and 692 in the accelerated and conservative group, were included. The average age (mean ± standard deviation) was 56.1 ± 8.7 and 56.6 ± 9 in the accelerated and conservative group. The mean follow-up was 12.5 months, ranging from 2 to 24 months. The meta-analysis showed no statistically significant differences in terms of retear rate between the groups (P = 0.29). The superiority of the accelerated group was demonstrated in terms of external rotation (P < 0.05) at 3-month follow-up; in terms of forward elevation, external rotation, abduction (P < 0.05), but not in terms of Constant-Murley score at 6-month follow-up; in terms of forward elevation (P < 0.05) at 12-month follow-up. No significant differences between the two group were highlighted at 24-month follow-up.ConclusionsNo statistically significant differences in the retear rate among the accelerated and conservative group have been demonstrated. On the other hand, statistically and clinically significant differences were found in terms of external rotation at 3 and 6 months of follow-up in favour of the accelerated group. However, no differences between the two groups were detected at 24 months follow-up.

【 授权许可】

CC BY