|
|
|
| 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.
|
|
|
|
|
|
[1] Rossi LA，Chahla J，Verma NN，et al. Rotator Cuff Retears [J]. JBJS Rev，2020，8（1）：e0039.
[2] Zhang C，Wu J，Li X，et al. Current Biological Strategies to Enhance Surgical Treatment for Rotator Cuff Repair[J]. Front Bioeng Biotechnol，2021，9：657584.
[3] Chard MD，Hazleman R，Hazleman BL，et al. Shoulder disorders in the elderly：a community survey [J]. Arthritis Rheum，1991，34（6）：766-769.
[4] Longo UG，Salvatore G，Rizzello G，et al. The burden of rotator cuff surgery in Italy：a nationwide registry study [J]. Arch Orthop Trauma Surg，2017，137（2）：217-224.
[5] Dierckman BD，Ni JJ，Karzel RP，et al. Excellent healing rates and patient satisfaction after arthroscopic repair of medium to large rotator cuff tears with a single-row technique augmented with bone marrow vents [J]. Knee Surg Sports Traumatol Arthrosc，2017，26（1）：136-145.
[6] Griffith R，Fretes N，Bolia IK，et al. Return-to-Sport Criteria After Upper Extremity Surgery in Athletes-A Scoping Review，Part 1：Rotator Cuff and Shoulder Stabilization Procedures [J]. Orthop J Sports Med，2021，9（8）：2325967 1211021827.
[7] Tie TA，Hong CK，Chua I，et al. The Chinese version of the American shoulder and elbow surgeons standardized shoulder assessment form questionnaire，patient self-report section：a cross-cultural adaptation and validation study [J]. BMC Musculoskelet Disord，2021，22（1）：382.
[8] Kanto K，L?覿hdeoja T，Paavola M，et al. Minimal important difference and patient acceptable symptom state for pain，Constant-Murley score and Simple Shoulder Test in patients with subacromial pain syndrome [J]. BMC Med Res Methodol，2021，21（1）：45.
[9] Arndt J，Clavert P，Mielcarek P，et al. Immediate passive motion versus immobilization after endoscopic supraspinatus tendon repair：a prospective randomized study [J]. Orthop Traumatol Surg Res，2012，98（6 Suppl）：S131-S138.
[10] Cuff DJ，Pupello DR. Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol [J]. J Shoulder Elbow Surg，2012，21（11）：1450-1455.
[11] Keener JD，Galatz LM，Stobbs-Cucchi G，et al. Rehabilitation following arthroscopic rotator cuff repair：a prospective randomized trial of immobilization compared with early motion [J]. J Bone Joint Surg Am，2014，96（1）：11-19.
[12] Kim YS，Chung SW，Kim JY，et al. Is early passive motion exercise necessary after arthroscopic rotator cuff repair? [J]. Am J Sports Med，2012，40（4）：815-821.
[13] Lee BG，Cho NS，Rhee YG. Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair：aggressive versus limited early passive exercises [J]. Arthroscopy，2012，28（1）：34-42.
[14] Papalia R，Franceschi F，Vasta S，et al. Shoulder stiffness and rotator cuff repair [J]. Br Med Bull，2012，104：163-174.
[15] Huberty DP，Schoolfield JD，Brady PC，et al. Incidence and treatment of postoperative stiffness following arthroscopic rotator cuff repair [J]. Arthroscopy，2009，25（8）：880-890.
[16] Spencer EE. Partial-thickness articular surface rotator cuff tears：an all-inside repair technique [J]. Clin Orthop Relat Res，2010，468（6）：1514-1520.
[17] Gartsman GM. Arthroscopic rotator cuff repair [J]. Clin Orthop Relat Res，2001，390：95-106.
[18] Gallagher BP，Bishop ME，Tjoumakaris FP，et al. Early versus delayed rehabilitation following arthroscopic rotator cuff repair：A systematic review [J]. Phys Sportsmed，2015，43（2）：178-187.
[19] Thomopoulos S，Williams GR，et al. Tendon to bone healing：differences in biomechanical，structural，and compositional properties due to a range of activity levels [J]. J Biomech Eng，2003，125（1）：106-113.
[20] Chan K，MacDermid JC，Hoppe DJ，et al. Delayed versus early motion after arthroscopic rotator cuff repair：a meta-analysis [J]. J Shoulder Elbow Surg，2014，23（11）：1631-1639.
[21] 沈翀，唐志宏，胡军祖，等.关节镜肩袖修补后早期功能锻炼的Meta分析[J].中国组织工程研究，2014，18（17）：2777-2782.
[22] Chen L，Peng K，Zhang D，et al. Rehabilitation protocol after arthroscopic rotator cuff repair：early versus delayed motion [J]. Int J Clin Exp Med，2015，8（6）：8329-8338.
[23] Shen PH，Lien SB，Shen HC，et al. Long-term functional outcomes after repair of rotator cuff tears correlated with atrophy of the supraspinatus muscles on magnetic resonance images [J]. J Shoulder Elbow Surg，2008，17（1 Suppl）：1s-7s.
[24] Kluczynski MA，Nayyar S，Marzo JM，et al. Early Versus Delayed Passive Range of Motion After Rotator Cuff Repair：A Systematic Review and Meta-analysis [J]. Am J Sports Med，2015，43（8）：2057-2063.
[25] Gibbons MC，Singh A，Engler AJ，et al. The role of mec-hanobiology in progression of rotator cuff muscle atrophy and degeneration [J]. J Orthop Res，2018，36（2）：546-556. |
|
|
|
