Should a Sling Be Used after Shoulder Surgery?In days past, shoulder surgery was always followed with the use of a soft sling or hard brace. The sling or brace kept the joint from moving during the healing. Having some scar tissue helped hold the joint stable.
With the new methods of surgery using arthroscopy, long periods of immobilization with a sling are no longer needed. Arthroscopy allows the doctor to insert a slender instrument right into the joint. This gives the doctor a view inside and makes it possible to repair the problem without opening up the entire joint.
One exception remains: the Bankart repair. This operation is used to repair a torn labrum. The labrum is the rim of cartilage that surrounds and deepens the shoulder socket. The repair can now be done with an arthroscope, but the sling is still used for days to weeks (depending on the doctor).
This study compared two groups of patients after the Bankart repair. One group had the regular rehab program with sling immobilization. The second group had an accelerated (faster) program. Group two only used the sling to sleep at night. They started moving the shoulder and exercising right from day one after the operation.
The researchers found no difference in the long-term results between these two groups. In other words, two years after the operation, everyone had the same amount of motion, strength, and function. What they did find was a big difference in the short-term results.
Right away, the group without the sling who had early movement had less pain. They also regained motion and strength much faster. Patients in the accelerated rehab were happier with the program than patients in regular rehab.
Some doctors continue to use a sling with patients after the Bankart repair. It has long been thought that the shoulder is less stable and to be held immobile for a longer time after a Bankart. The authors of this study think early movement is safe after a Bankart repair for a small tear of the labrum.
Seung-Ho Kim, MD, et al. Accelerated Rehabilitation after Arthroscopic Bankart Repair for Selected Cases: A Prospective Randomized Clinical Study. In Arthroscopy. September 2003. Vol. 19. No. 7. Pp. 722-731.
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