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Rotator Cuff repair rehabilitation

Stephen J Nicholas, Steven J Lee, Michael J Mullaney, Timothy F Tyler, Takumi Fukunaga, Christopher D Johnson, Malachy P McHugh
BACKGROUND: The functional benefits of double-row (DR) versus single-row (SR) rotator cuff repair are not clearly established. PURPOSE: To examine the effect of DR versus SR rotator cuff repair on functional outcomes and strength recovery in patients with full-thickness tears. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: Forty-nine patients were randomized to DR or SR repairs; 36 patients (13 women, 23 men; mean age, 62 ± 7 years; 20 SR, 16 DR) were assessed at a mean 2...
October 2016: Orthopaedic Journal of Sports Medicine
Dirk Kokmeyer, Eric Dube, Peter J Millett
BACKGROUND: Rehabilitation after rotator cuff repair surgery has been the focus of several clinical trials in the past decade. Many illuminate new evidence with regard to the prognosis of structural and functional success after surgery. METHODS: A selective literature search was performed and personal physiotherapeutic and surgical experiences are reported. RESULTS: Post-operative rehabilitation parameters, namely the decision to delay or allow early range of motion after surgery, play a large role in the overall success after surgery...
2016: Open Orthopaedics Journal
Jessica M Fritz, Ryan R Inawat, Brooke A Slavens, John R McGuire, Dean W Ziegler, Sergey S Tarima, Steven I Grindel, Gerald F Harris
BACKGROUND: The increasing demand for rotator cuff (RC) repair patients to return to work as soon as they are physically able has led to exploration of when this is feasible. Current guidelines from our orthopedic surgery clinic recommend a return to work at 9 weeks postoperation. To more fully define capacity to return to work, the current study was conducted using a unique series of quantitative tools. To date, no study has combined 3-dimensional (3D) motion analysis with electromyography (EMG) assessment during activities of daily living (ADLs), including desk tasks, and commonly prescribed rehabilitation exercise...
September 14, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Jason D Woollard, James E Bost, Sara R Piva, G Kelley Fitzgerald, Mark W Rodosky, James J Irrgang
PURPOSE: Minimal research has examined the prognostic ability of shoulder examination data or psychosocial factors in predicting patient-reported disability following surgery for rotator cuff pathology. The purpose of this study was to examine these factors for prognostic value in order to help clinicians and patients understand preoperative factors that impact disability following surgery. METHODS: Sixty-two patients scheduled for subacromial decompression with or without supraspinatus repair were recruited...
August 22, 2016: Disability and Rehabilitation
Johannes Barth, Kevin Andrieu, Elias Fotiadis, Gerjon Hannink, Renaud Barthelemy, Mo Saffarini
PURPOSE: The incidence of retear following rotator cuff repair remains a major concern, and the cause and timing of retear remain unclear. The aim of this study was to prospectively investigate the timing of retears following rotator cuff repair at multiple time intervals. The hypothesis was that the 'critical period' for retears extends beyond the first three post-operative months. METHODS: The authors prospectively studied 206 shoulders that underwent arthroscopic double-row (without suture bridge) suture anchor repair for rotator cuff tears...
August 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Warren R Dunn, John E Kuhn, Rosemary Sanders, Qi An, Keith M Baumgarten, Julie Y Bishop, Robert H Brophy, James L Carey, Frank Harrell, Brian G Holloway, Grant L Jones, C Benjamin Ma, Robert G Marx, Eric C McCarty, Sourav K Poddar, Matthew V Smith, Edwin E Spencer, Armando F Vidal, Brian R Wolf, Rick W Wright
BACKGROUND: The purpose of this study is to help define the indications for rotator cuff repair by identifying predictors of failure of nonoperative treatment. METHODS: A prospective, multicenter, cohort study design was used. All patients with full-thickness rotator cuff tears on magnetic resonance imaging were offered participation. Baseline data from this cohort were used to examine risk factors for failing a standard rehabilitation protocol. Patients who underwent surgery were defined as failing nonoperative treatment...
August 2016: Journal of Shoulder and Elbow Surgery
Yoshihiro Kai, Masafumi Gotoh, Kazuto Takei, Kazuya Madokoro, Takeshi Imura, Shin Murata, Toru Morihara, Naoto Shiba
[Purpose] Early postoperative passive motion exercise after arthroscopic rotator cuff repair remains controversial. To better understand this issue, this study was aimed at evaluating scapular kinematics and muscle activities during passive arm elevation in healthy subjects. [Subjects and Methods] The dominant shoulders of 27 healthy subjects were examined. Electromagnetic sensors attached to the scapula, thorax, and humerus were used to determine three-dimensional scapular kinematics during active arm elevation with or without external loads and passive arm elevation...
June 2016: Journal of Physical Therapy Science
Anssi Ryösä, Katri Laimi, Ville Äärimaa, Kaisa Lehtimäki, Juha Kukkonen, Mikhail Saltychev
PURPOSE: Comparative evidence on treating rotator cuff tear is inconclusive. The objective of this review was to evaluate the evidence on effectiveness of tendon repair in reducing pain and improving function of the shoulder when compared with conservative treatment of symptomatic rotator cuff tear. METHOD: Search on CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science and Pedro databases. Randomised controlled trials (RCT) comparing surgery and conservative treatment of rotator cuff tear...
July 6, 2016: Disability and Rehabilitation
Stefano Gumina, Rosanna Izzo, Giovanni Pintabona, Vittorio Candela, Riccardo Savastano, Valter Santilli
BACKGROUND: Mobility recovery after arthroscopic rotator cuff repair in different tears size. AIM: To investigate, after arthroscopic rotator cuff repair, the range of motion (ROM) progression in different sized tears (small, large and massive), and evaluating ROM changes in the pre and postoperative periods of each group. DESIGN: cohort study. SETTING: Policlinico Umberto I, "Sapienza" University, Rome, Italy. POPULATION: 92 patients with reparable rotator cuff tears...
June 22, 2016: European Journal of Physical and Rehabilitation Medicine
Guido Spargoli
UNLABELLED: Rotator cuff pathology can contribute to shoulder pain and may affect the performance of sport activities, work, and activities of daily living. The partial articular supraspinatus tendon avulsion (PASTA) lesion represents a very common type of rotator cuff pathology seen in rehabilitation. When conservative treatment fails, surgery is generally required. Success of recovery depends on several factors, including: repair techniques, healing process related to timing, rehabilitation programs, and patient compliance with home exercises...
June 2016: International Journal of Sports Physical Therapy
Sang-Jin Shin, Nam-Hoon Do, Juyeob Lee, Young-Won Ko
BACKGROUND: Corticosteroid injections have been widely used for reducing shoulder pain. However, catastrophic complications induced by corticosteroid such as infections and tendon degeneration have made surgeons hesitant to use a corticosteroid injection as a pain control modality, especially during the postoperative recovery phase. PURPOSE: To determine the effectiveness and safety of a subacromial corticosteroid injection for persistent pain control during the recovery period and to analyze the factors causing persistent pain after arthroscopic rotator cuff repair...
September 2016: American Journal of Sports Medicine
Fabio Antonio Vieira, Paul Juma Olawa, Paulo Santoro Belangero, Gustavo Gonçalves Arliani, Eduardo Antônio Figueiredo, Benno Ejnisman
OBJECTIVE: To map out the approaches used by Brazilian orthopedists in treating complete tears of the rotator cuff. METHODS: A multiple-choice questionnaire was handed out to 232 orthopedists at the 45th Brazilian Congress of Orthopedics and Traumatology. Of these, 207 were returned but five were incomplete and were excluded. Thus, 202 questionnaires were used. RESULTS: Among the orthopedists who answered the questionnaires, around 60% were from the southeastern region and 46% were shoulder and elbow surgeons...
November 2015: Revista Brasileira de Ortopedia
Maike Mueller, Gregory Hoy, Ruben Branson
INTRODUCTION: Professional sports injuries are usually all dealt with at one single operation to return the player to the sport after appropriate rehabilitation. We questioned the assumption that rotator cuff tears must be repaired concurrently with instability syndromes, and aimed to allow a professional rugby league player to achieve career goals by NOT correcting all pathology at one surgery. CASE PRESENTATION: A professional rugby league player presented with acute shoulder instability on a setting of a chronic full thickness rotator cuff tear...
March 2016: Asian Journal of Sports Medicine
Keith M Baumgarten, Roy Osborn, Will E Schweinle, Matthew J Zens, Elizabeth A Helsper
BACKGROUND: There are few level 1 or 2 evidence studies that examine rehabilitation after rotator cuff repair. Pulleys have been used in postoperative shoulder rehabilitation with the intention of improving range of motion and developing strength. There is a concern that the use of pulleys in rehabilitation of rotator cuff repairs may contribute to excessive scapular motion (scapular substitution) and potentially inferior outcomes. HYPOTHESIS: Rotator cuff repair patients treated with pulley exercises would have increased scapular substitution and inferior patient-determined outcome scores, range of motion, and strength compared with patients treated with an alternative rehabilitation program without pulleys...
July 2016: American Journal of Sports Medicine
Alexandre Lädermann, Patrick J Denard, Stephen S Burkhart
IMPORTANCE: Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. AIM OR OBJECTIVE: The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. EVIDENCE REVIEW: A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR...
January 2016: Journal of ISAKOS
Peter Edwards, Jay Ebert, Brendan Joss, Gev Bhabra, Tim Ackland, Allan Wang
UNLABELLED: The incidence of rotator cuff tears increases with age, with full-thickness rotator cuff tears present in approximately 25% of individuals in their sixties, and more than 50% of those in their eighties. While surgery is considered an effective treatment, recurrent tears at the insertion site are common, especially with degenerative tears, which are frequent in the older population. More recently, there has been increasing interest in exercise rehabilitation and physical therapy as a means to manage partial and full thickness tears of the rotator cuff by addressing weakness and functional deficits...
April 2016: International Journal of Sports Physical Therapy
Satoshi Shimo, Yuta Sakamoto, Akinari Tokiyoshi, Yasuhiro Yamamoto
[Purpose] The effect of early rehabilitation protocols after arthroscopic rotator cuff repair is currently unknown. We examined short-term effects of early rehabilitation on functional outcomes and activities of daily living after arthroscopic rotator cuff repair. [Subject and Methods] An 82-year-old male fell during a walk, resulting in a supraspinatus tear. Arthroscopic rotator cuff repair was performed using a single-row technique. He wore an abduction brace for 6 weeks after surgery. [Results] From day 1 after surgery, passive range of motion exercises, including forward flexion and internal and external rotation were performed twice per day...
January 2016: Journal of Physical Therapy Science
Adrien J P Schwitzguébel, Céline Haas, Alexandre Lädermann
Shoulder pain is a common problem for general practitioners. The objectives of a shoulder arthroplasty are to improve the articular function and to provide pain relief. Anatomic shoulder arthroplasty is not the treatment of choice if a rotator cuff deficiency is associated with arthritis. In some circumstances (muscle or tendon deficiency) rotator cuff repair is technically impossible. Reverse shoulder arthroplasty (RSA) has opened new opportunities for patients suffering with shoulder conditions such as shoulder pseudoparalysis and revision surgery...
February 3, 2016: Revue Médicale Suisse
Charles A Thigpen, Michael A Shaffer, Bryce W Gaunt, Brian G Leggin, Gerald R Williams, Reg B Wilcox
This is a consensus statement on rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The purpose of this statement is to aid clinical decision making during the rehabilitation of patients after arthroscopic rotator cuff repair. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. This statement describes a rehabilitation framework that includes a 2-week period of strict immobilization and a staged introduction of protected, passive range of motion during weeks 2-6 postoperatively, followed by restoration of active range of motion, and then progressive strengthening beginning at postoperative week 12...
April 2016: Journal of Shoulder and Elbow Surgery
Alessandro Castagna, Silvana DE Giorgi, Raffaele Garofalo, Marco Conti, Silvio Tafuri, Biagio Moretti
PURPOSE: the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair. METHODS: from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2)...
October 2015: Joints
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