Since rotator cuff repair surgeries have become popularized, almost every aspect of the surgery protocol has been debated. Common protocol instructs a patient to wear a sling for 3-4 weeks post-surgery, and then introduce gentle range of motion exercises to begin to regain flexibility and strength later. A new study though, published in the March 19, 2019 issue of The Journal of Bone and Joint Surgery set out to test the effectiveness of wearing a sling after arthroscopic surgery for patients with small-medium sized rotator cuff tears.
The Study
The sample sized included 80 patients who were going in for an arthroscopic repair of less than 3 centimeters. 40 patients were instructed not to wear a sling for the first four weeks after surgery, while the other 40 were instructed to wear a sling for the first four weeks after surgery and were not allowed to perform any active motion, as is the common practice.
After, both groups were instructed to do passive range of motion exercises for four weeks and then moved on to active mobilization and other strengthening exercises.
The Results
Ten days after surgery, patients were asked to rate their pain on a visual scale, and both groups averaged about a 5 on a scale of 1-10. After 3 months post-op, the group without shoulder slings showed greater shoulder elevation, but by 6 months post-op, both groups showed about the same improvement in range of movement.
Also, at six months, some interesting differences began to surface for the two groups in their reported SANE scale and pain level. The group who didn’t use a sling after surgery reported their SANE at a level of 86% of normal while the other group rated theirs at a 79% and the group who didn’t use a sling reported their pain at a lower level as well. Their pain level was rated at .8 out of 10, while the group who used slings reported theirs as a 1.5 out of 10.
The results show that the no-sling approach with early movement leads to faster recovery of shoulder motion, less pain, and better overall patient ratings throughout the six months after surgery.
There is a growing body of research that shows that early movement after shoulder surgery reduces the risk of atrophy, encourages a better range of motion and allows patients to return earlier to their normal activities. This study confirms other results of other recent studies showing the benefits of early mobilization after surgery.
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SOURCE: https://journals.lww.com/jbjsjournal/Fulltext/2019/03200/No_Sling_After_Rotator_Cuff_Repair__Balancing.14.aspx?PRID=JBS_PR_032119
