Compare of rehabilitation efficacy between early and delayed passive motion in patients undergoing arthroscopic rotator cuff repair：a meta-analysis#br#
GAO Kai1 WANG Xiaofei1 LI Yufu1 WANG Huajun2 GAO Yanping2 ZHENG Wei1 LI Jia3 LI Ling3
1.Department of Orthopedics, the Third Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050000, China;
2.Department of Orthopedics, the First Clinical College of Jinan University, Guangdong Province, Guangzhou 510630, China;
3.Department of Rheumatology and Immunology, Guangdong Provincial People’s Hospital, Guangdong Province, Guangzhou 510080, China
Abstract：Objective To systematically evaluate the effect of early and delayed passive motion programs on postoperative functional rehabilitation after arthroscopic rotator cuff repair. Methods Cochrane Library (Issue 5, 2021), PubMed, EMbase, CNKI, VIP, Wanfang, and Chinese biomedical literature database were searched by computer. The retrieval time was set from the earliest time provided by the database to May 2021. Randomized controlled trials (RCT) were conducted to determine the efficacy of early and delayed passive motion after arthroscopic rotator cuff repair. This study was divided into the early passive motion group and the delayed passive motion group. The maximum flexion angle of shoulder joint, maximum external rotation angle of shoulder joint, American Shoulder and Elbow Surgeons (ASES) score, simple shoulder test (SST) score and the incidence of rotator cuff retear in the last follow-up were compared between the two groups twelve months after surgery. Meta-analysis was performed using RevMan 5.3. Results A total of 443 patients were included in five RCTs. Meta-analysis results showed that: twelve months after surgery, the maximum flexion angle of shoulder joint of the early passive motion group was higher than that of the delayed passive motion group, the difference was statistically significant (MD = 1.22, 95%CI: 0.21 to 2.23, P = 0.02); there was no significant difference in the maximum external rotation angle of shoulder joint between the two groups (MD = 2.30, 95%CI: -2.31 to 6.92, P = 0.33); there was no significant difference in ASES scores between the two groups (MD = -2.71, 95%CI: -6.99 to 1.58, P = 0.22); there was no significant difference in SST score between the two groups (MD = 0.15, 95%CI: -0.55 to 0.84, P = 0.68). There was no significant difference in rotator cuff tear rate between the two groups at the last follow-up (RR = 0.79, 95%CI: 0.54 to 1.15, P = 0.22). Conclusion Early passive motion can obtain more satisfactory shoulder function than delayed passive motion, and the safety of both is similar.
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