Is early passive motion exercise necessary after arthroscopic rotator cuff repair?

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Rehabilitation Science

Background:

• Early passive motion (EPM) is a standard post-rotator cuff repair (RCR) protocol to prevent stiffness.
• Emerging evidence suggests prolonged immobilization may improve tendon healing and quality.

Purpose of the Study:

• To determine if EPM impacts functional outcomes and tendon healing after arthroscopic RCR.
• To compare functional recovery and retear rates between EPM and immobilization groups.

Main Methods:

• Level 1 evidence randomized controlled trial (RCT) involving 105 patients with small to medium RCR.
• Patients were randomized to EPM during brace wear (Group 1) or immobilization (Group 2).
• Outcomes measured included range of motion (ROM), pain (VAS), functional scores (Constant, SST, ASES), and cuff integrity via imaging.

Main Results:

• No significant differences were observed in ROM, pain, or functional scores between groups at 12 months.
• Final Constant scores (69.8 vs. 69.8), SST (9.0 vs. 9.0), and ASES (73.3 vs. 82.9) showed no statistical difference.
• Rotator cuff re-tear rates were comparable: 12% in the EPM group versus 18% in the immobilization group (P=.429).

Conclusions:

• EPM after arthroscopic RCR does not accelerate ROM or pain relief.
• EPM does not negatively impact rotator cuff healing rates.
• EPM is not essential for small to medium RCR, allowing for tailored rehabilitation protocols.