Issue:

Surgical repair has been shown to be an effective treatment of full-thickness rotator cuff (RC) tears. However, post-surgical rehabilitation is prolonged (4-12 months), and patients are frequently immobilized in a sling for 4-6 weeks postoperatively to protect the surgical repair. This period of immobilization and subsequent delay in range of motion (ROM) initiation may be unnecessary and may delay recovery and the potential for earlier return-to-modified- work/activities of daily living. Patients suffering from RC tears are often of working age, so a prolonged period of immobilization not only affects quality of life and daily function, but has societal implications in terms of time lost from work, reduced productivity, and an inability to engage in certain leisure-time physical activities.

Objectives:

The primary objective of our systematic review is to consolidate the existing evidence on the early postoperative management of patients undergoing mini-open or arthroscopic RC repairs to determine the impact of early mobilization versus immobilization within the first 4-6 weeks postoperatively on 1) time to return to work, both modified and full duties; 2) healing rates of the repaired tendons; 3) shoulder power and 4) health-related quality of life (HRQL).

Anticipated Results:

We believe that early active ROM may decrease the time to return to modified duties for patients recovering from RC repairs. If this hypothesis is true, WCB claimants may be able to return to work for sedentary or modified duties earlier than 6 weeks.

With a focus on finding the best evidence for the amount and type of movement allowed after RC repair, our project is promoting effective management of a common injury and facilitating evidence-based decisions for return to work and activity for this population. We will increase knowledge of clinicians, case managers and patients on expectations of treatment and recovery after RC repair. It will also promote a positive health culture through re-assurance to patients and their employers about the trajectory of recovery after RC repairs.

Investigators:

Dr. Lauren Beaupre, University of Alberta