Early Versus Delayed Mobilization After Rotator Cuff Repair: A Systematic Review of Re-tear Rates, Pain, Function,...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Physical Therapy

Background:

• Rotator cuff tears are common musculoskeletal conditions with increasing surgical repair rates.
• High re-tear rates persist despite surgical advances, especially for large tears.
• Optimal postoperative rehabilitation timing remains debated, balancing stiffness vs. re-tear risk.

Purpose of the Study:

• To systematically review evidence comparing early vs. delayed mobilization after rotator cuff repair.
• To assess the impact of mobilization timing on re-tear rates, pain, function, and range of motion.
• To provide evidence-based guidance for postoperative rehabilitation protocols.

Main Methods:

• Systematic literature search of PubMed, Cochrane Library, and Google Scholar (February 2026).
• Inclusion of studies comparing early (1-4 weeks) vs. delayed (≥4-6 weeks) active/passive mobilization post-rotator cuff repair.
• Assessment of re-tear rates, VAS pain, ASES, Constant, UCLA, WORC, DASH scores, and range of motion; risk of bias and certainty of evidence evaluated.

Main Results:

• Twelve studies (10 RCTs, 2 cohort; 1,255 patients) included.
• No significant difference in re-tear rates between early and delayed mobilization groups.
• Early mobilization showed short-term range of motion improvements (forward flexion, external rotation) without compromising long-term function or significantly increasing pain.

Conclusions:

• Early active mobilization post-rotator cuff repair does not elevate re-tear rates.
• Short-term range of motion benefits are observed with early mobilization.
• Long-term functional outcomes are comparable; individualized rehabilitation based on tear size and tissue quality is recommended.