Issue:
Surgical repair has been shown to be an effective treatment of full-thickness rotator cuff tears; however, recovery time following surgery is prolonged.
The current standard of practice in most North American centers is to immobilize the shoulder in a sling for the first four to six post-operative weeks. This delay in range of motion (ROM) initiation may be unnecessary and may encourage development of post-operative stiffness, delaying
recovery and return-to-work.
In 2011, we initiated a randomized controlled trial to investigate whether patients may safely initiate active ROM following arthroscopic rotator cuff repair, as soon as pain and comfort allow. A total of 200 patients will be recruited. To date, we have 96 subjects who have undergone surgery and are randomized and another 34 subjects who are enrolled and waiting for surgery. Our goal is to recruit and randomize the remaining subjects over the next 12-18 months. All subjects will be followed up for a period of 2 years after randomization. With the funds awarded from WCB, we are
planning to evaluate all the subjects in this study 12 months postoperatively, which is an acceptable clinical time frame to assess for rotator cuff integrity post-surgery.
Objectives:
The specific objectives of the present study are to determine if, when compared to a standard rehabilitation protocol, early active ROM initiation
following arthroscopic RC repair is associated with:
1) Improved shoulder ROM at 6 weeks and 3 months post-operatively;
2) Improved disease-specific HRQL at 6 weeks and 3 months post- operatively, and
3) Post-operative adverse events or RC healing at 1-year post-operatively. We will also assess differences in the above outcomes based on RC tear size and demographic factors.
Anticipated Results:
We believe the results of the ultrasound examination analyzed by a fellowship trained musculoskeletal radiologist will add essential information about the safety and potential impact of early ROM after rotator cuff arthroscopic repair. This will help to guide treatment and rehabilitative recommendations, assist recovery, and improve outcomes.
Investigators:
Dr David Sheps (University of Alberta)
