Setting patients' expectations for range of motion after arthroscopic rotator cuff repair

Arthroscopic rotator cuff repair is a reliable option for symptomatic patients who have failed conservative treatments. Limited evidence exists regarding early rehabilitation time points (less than 1 year) and the influence of tear size. The authors sought to determine whether a difference exists in pre- and postoperative range of motion among small, medium, and large isolated rotator cuff tears treated arthroscopically. Patient- and tear-specific demographics were analyzed in a retrospective series of patients who had undergone arthroscopic rotator cuff repair. Two hundred seventy-four patients (153 [56%] men and 121 [44%] women; mean age, 53 years) were analyzed. Small tears (n=158 [58%]) were more common than medium (n=70 [25%]) and large (n=46 [17%]) tears. Shoulder range of motion was measured preoperatively and at 2 and 6 weeks, 3 and 6 months, and 1 year postoperatively. At nearly all time points pre- and postoperatively, large tears were significantly stiffer than small tears in external rotation and forward elevation (P<.05). It takes 1 year to fully regain external rotation after small and medium tears, whereas mild residual stiffness remains after large tears. Full forward elevation is restored by 3 months for small tears vs 6 months for medium and large tears. Significant tear size-dependent differences exist in shoulder range of motion after arthroscopic repair of isolated rotator cuff tears. These data can be used to manage patients' expectations for range of motion after arthroscopic rotator cuff repair to improve patient satisfaction.