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Rotator Cuff repair rehabilitation

Christian Jung, Lena Tepohl, Reina Tholen, Knut Beitzel, Stefan Buchmann, Thomas Gottfried, Casper Grim, Bettina Mauch, Gert Krischak, Hans Ortmann, Christian Schoch, Frieder Mauch
Background: Tears and lesions of the rotator cuff are a frequent cause of shoulder pain and disability. Surgical repair of the rotator cuff is a valuable procedure to improve shoulder function and decrease pain. However, there is no consensus concerning the rehabilitation protocol following surgery. Objectives: To review and evaluate current rehabilitation contents and protocols after rotator cuff repair by reviewing the existing scientific literature and providing an overview of the clinical practice of selected German Society of Shoulder and Elbow Surgery e...
2018: Obere Extremität
Shuxiang Li, Han Sun, Xiaomin Luo, Kun Wang, Guofeng Wu, Jian Zhou, Peng Wang, Xiaoliang Sun
BACKGROUND: The argument on the recommended rehabilitation protocol following arthroscopic rotator cuff repair remains to be resolved. So this meta-analysis was presented to evaluate the differences of clinical effects between the 2 distinct rehabilitation protocols after arthroscopic rotator cuff repair. METHODS: The PubMed, Cochrane Library, Web of Science, and EMBASE were systematically searched. Only randomized controlled trials (RCTs) published up to July 25, 2017, comparing early passive motion (EPM) versus delayed passive motion (DPM) rehabilitation protocols following arthroscopic rotator cuff repair were identified...
January 2018: Medicine (Baltimore)
Terrance A Sgroi, Michelle Cilenti
PURPOSE OF REVIEW: With improvements in surgical techniques and increased knowledge of rotator cuff healing, there was a need to identify a safe progression after rotator cuff repair. The rehabilitation specialist plays an integral role in the care of these patients, and by implementing an evidence and criteria-based model, patients may be able to return to their prior levels of function sooner with fewer complications. RECENT FINDINGS: Timing of progression for rotator cuff patients should align not only with healing but also potential strain on the involved tissue...
February 5, 2018: Current Reviews in Musculoskeletal Medicine
Edward Shields, Caroline Thirukumaran, Katia Noyes, Ilya Voloshin
Background: Workers' compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers' compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques. Methods: An all workers' compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
Annie Ys Lau, Kalman Piper, Desmond Bokor, Paige Martin, Victor Sl Lau, Enrico Coiera
BACKGROUND: Translating research into practice, especially the implementation of digital health technologies in routine care, is increasingly important. Yet, there are few studies examining the challenges of implementing patient-facing digital technologies in health care settings. OBJECTIVE: The aim of this study was to report challenges experienced when implementing mobile apps for patients to support their postsurgical rehabilitation in an orthopedic setting. METHODS: A mobile app was tailored to the needs of patients undergoing rotator cuff repair...
December 7, 2017: JMIR Human Factors
Sascha J Baettig, Karl Wieser, Christian Gerber
BACKGROUND: Obtaining patient satisfaction is a key goal of surgical treatment. It was the purpose of this study to identify pre-, peri- and postoperative factors determining patient satisfaction after shoulder surgery, quantify their relative importance and thereby allow the surgeon to focus on parameters, which will influence patient satisfaction. METHODS: We retrospectively reviewed 505 patients, who underwent either rotator cuff repair (n = 216) or total shoulder arthroplasty (n = 289)...
November 15, 2017: BMC Musculoskeletal Disorders
Bassem T Elhassan, Ryan M Cox, Dave R Shukla, Julia Lee, Anand M Murthi, Robert Z Tashjian, Joseph A Abboud
Management of failed rotator cuff repair may be difficult, especially in young patients. Various nonmodifiable and modifiable patient factors, including age, tendon quality, rotator cuff tear characteristics, acute or chronic rotator cuff tear, bone quality, tobacco use, and medications, affect rotator cuff repair healing. Surgical variables, such as the technique, timing, tension on the repair, the biomechanical construct, and fixation, as well as the postoperative rehabilitation strategy also affect rotator cuff repair healing...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
Jae Chul Yoo, Tae Kang Lim, Dong Hyok Kim, Kyoung-Hwan Koh
PURPOSE: Symptomatic full-thickness rotator cuff (RC) tears are often recommended for surgical repairs. However, some patients decide not to have surgery. The aim of this study was to see if there was any difference in preoperative variables between the two groups. METHODS: 137 consecutive patients recommended for surgery due to symptomatic full-thickness RC tear were evaluated. At mean 58.1 months after surgery-recommendation, the patients were asked whether they had surgery and their clinical outcome was assessed...
October 8, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Rudolf Raschhofer, Nikos Poulios, Wolfgang Schimetta, Rüdiger Kisling, Christian Mittermaier
OBJECTIVE: To compare two different rehabilitation strategies, primary passive motion versus early isometric loading of the rotator cuff. DESIGN: Prospective randomized controlled observer-blinded pilot study. SETTING: Institute of Physical Medicine and Rehabilitation. SUBJECTS: Thirty patients after rotator cuff surgery. INTERVENTION: All participants were randomly assigned to one of the two outpatient treatment groups: primary passive motion versus early isometric loading of the rotator cuff...
October 2017: Clinical Rehabilitation
Hisahiro Tonotsuka, Hiroyuki Sugaya, Norimasa Takahashi, Nobuaki Kawai, Hajime Sugiyama, Keishi Marumo
PURPOSE: The postoperative protocol after arthroscopic rotator cuff repair (ARCR) is still controversial. Some surgeons recommend slower rehabilitation in order to improve the integrity of the repair, while others prefer early range-of-motion (ROM) exercise to avoid postoperative stiffness. The purpose of this study was to determine target ROM (T-ROM) measurements at 3 months after ARCR that are predictive of eventual full recovery without structural failure. METHODS: The cases consisted of 374 shoulders in 360 patients who underwent primary ARCR and were followed up for at least 2 years...
September 2017: Journal of Orthopaedic Surgery
H C Basat, C Kirçil, M Armangil, M Demirtş
BACKGROUND: The treatment of massive irreparable rotator cuff rupture has still no consensus among shoulder surgeons. It is assumed that symptomatic rotator cuff tendon rupture is accepted as irreparable if retraction amount of tendon is Patte stage 3 on MRI; degree of fatty atrophy is Goutallier stage 3 or 4; narrowing of acromiohumeral distance is lesser than 7 mm and excursion of tendon to repair has decreased and patient has severe pain. Biodegradable balloon is one of the newest methods for the treatment of irreparable massive rotator cuff ruptures...
August 2017: Nigerian Journal of Clinical Practice
Angelo De Carli, Mattia Fabbri, Riccardo Maria Lanzetti, Alessandro Ciompi, Edoardo Gaj, Gioia Beccarini, Mario Vetrano, Andrea Ferretti
BACKGROUND: The aim of this study was to compare rehabilitation protocol and operative treatment in a population of patients with a diagnosis of small to medium rotator cuff tears (≤3 cm), the null hypothesis being that there would been no difference in terms of clinical outcomes and patient's satisfaction between the rehabilitation protocol and the surgical treatment. METHODS: Patients with small to medium supraspinatus tears were retrospectively enrolled in this study and divided in 2 groups: arthroscopic repair (group A, 20 patients) and reinstated (group B, 18 patients)...
January 2017: Muscles, Ligaments and Tendons Journal
Peter K Edwards, Jay R Ebert, Chris Littlewood, Tim Ackland, Allan Wang
Study Design Systematic review. Background Electromyography (EMG) has previously been used to guide postoperative rehabilitation progression following rotator cuff repair to prevent deleterious loading of early surgical repair. Objective To review the current literature investigating EMG during rehabilitation exercises in normal shoulders, and to identify exercises that meet a cut point of 15% maximal voluntary isometric contraction (MVIC) or less and are unlikely to result in excessive loading in the early postoperative stages...
December 2017: Journal of Orthopaedic and Sports Physical Therapy
Bryan M Saltzman, William A Zuke, Beatrice Go, Randy Mascarenhas, Nikhil N Verma, Brian J Cole, Anthony A Romeo, Brian Forsythe
BACKGROUND: The aims of the study were as follows: to perform a systematic review of meta-analyses comparing "early motion" and "delayed motion" after arthroscopic rotator cuff repair; to provide a framework to analyze the best available evidence to develop recommendations; and to identify gaps where suggestions could be made for future investigations. METHODS: Literature searches were performed to identify meta-analyses examining arthroscopic rotator cuff repair with early-motion vs...
September 2017: Journal of Shoulder and Elbow Surgery
Larry D Field
Whether to use an immediate range of motion exercise protocol or, rather, to delay the initiation of rehabilitation exercises for patients after arthroscopic rotator cuff repair presents a significant dilemma for the treating surgeon. The study "The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair" by Mazzocca, Arciero, Shea, Apostolakos, Solovyova, Gomlinski, Wojcik, Tafuto, Stock, and Cote reveals that no differences in quality of life scores or rotator cuff healing were identified after comparing 2 groups of patients undergoing either immediate (within 3 days) or delayed (after 28 days) postoperative rehabilitation protocols...
June 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Bernardo Gialanella, Francesco Grossetti, Marina Mazza, Laura Danna, Laura Comini
CONTEXT: Surgical cuff repair is indicated in full-thickness rotator cuff tear when non-operative treatment fails. Surgical cuff repair can comprehend surgery of long head of the biceps when concomitant biceps pathology is present. However, the studies executed up to now do not have yet clearly defined if additional biceps surgery affects the shoulder functionality in patients who underwent rotator cuff repair. OBJECTIVE: The aim of this study is to verify if the concomitant biceps surgery prejudices the shoulder functionality during the short-term period in rotator cuff repair patients...
May 22, 2017: Journal of Sport Rehabilitation
John M Tokish, Thomas C Alexander, Michael J Kissenberth, Richard J Hawkins
BACKGROUND: Pseudoparalysis remains one of the most challenging conditions in shoulder surgery. Long thought of as an unsolvable problem, recent advances in surgical techniques offer potential return of overhead motion in the setting of massive irreparable rotator cuff tears. This article summarizes the available literature including existing definitions and the results of different treatment approaches regarding range of motion, outcome scores, and reversal. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the MEDLINE database, Cochrane database, Physiotherapy Evidence Database, and Google Scholar database was performed for studies that defined a preoperative shoulder group as having pseudoparalysis...
June 2017: Journal of Shoulder and Elbow Surgery
Travis Orth, Jessica Paré, John E Froehlich
CONTEXT: Recent advances within the field of genetics are currently changing many of the methodologies in which medicine is practiced. These advances are also beginning to influence the manner in which physical therapy services are rendered. Rotator cuff pathology is one of the most common diagnoses treated by the sports physical therapist. The purpose of this commentary is to educate sports physical therapists on the recent advances regarding how genetics influences rotator cuff pathology, including rotator cuff tears, and provide a perspective on how this information will likely influence post-operative shoulder rehabilitation in the near future...
April 2017: International Journal of Sports Physical Therapy
Brian J Cole, Eric J Cotter, Kevin C Wang, Annabelle Davey
Rotator cuff injuries are among the most common in orthopaedics, with rotator cuff repair surgery consistently reported as one of the most commonly performed orthopaedic procedures. Patient satisfaction is becoming an increasingly important outcome metric as health care continues to evolve with regard to quality measures affecting physician reimbursement. Evidence supports that postoperative patient satisfaction, an important quality outcome metric, is highly influenced by preoperative patient expectations, which are in turn governed by patient knowledge and understanding...
August 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ourania Nikolaidou, Stefania Migkou, Christos Karampalis
BACKGROUND: Rotator cuff tears are a very common condition that is often incapacitating. Whether non-surgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. If conservative management is insufficient, surgical repair is often indicated. Postsurgical outcomes for patients having had rotator cuff repair can be quite good. A successful outcome is much dependent on surgical technique as it is on rehabilitation. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on clinical experience and expert opinion...
2017: Open Orthopaedics Journal
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