I'm going to have rotator cuff surgery in a few days. So, I'm surfing the web looking for any information I can find to guide me after surgery. Is there a set way to get maximum recovery as quickly as possible?
If you went from surgeon-to-surgeon, state-to-state, and region-to-region in the United States you would not find one single rehab program used by all for patients who have had surgery for a rotator cuff tear.
And that's true even though everyone agrees that patients must closely follow the postoperative Dos and Don'ts they are given. One of those Dos is to complete their rehab program from start to finish.
The authors of a recent study set out to review all of the published studies on rehabilitation for rotator cuff repairs. They wanted to see if there was enough evidence in a systematic review of this type to say just what is the optimal evidence-based rehab protocol for this problem.
They set their standard for studies to be included to those that were high-quality (Levels I and II)
evidence. The studies had to involve randomized clinical trials of patients who had rehabilitation after surgery to repair the damaged rotator cuff.
Even after searching all of the most reputable databases, they only found 12 studies published over a
40-year period (1966 to 2008). And only four of those studies were appropriate because they met all the criteria set up by the review committee to qualify as a Level I or II high-quality evidence-based study.
These four studies were limited to reviewing the results of continuous passive motion (CPM) after surgery and the use of supervised physical therapy versus unsupervised home exercise. The authors made it clear that each of these four studies had some weaknesses. The strength of the evidence was called into question because of those design flaws. So although they present the results, they advise the reader to consider the conclusions carefully.
There is clearly a need for some high-quality trials to investigate the optimal rehab program for rotator cuff repairs. Just looking at one aspect of rehab (whether that is CPM, physical therapy, exercise or some other intervention), is not likely to answer the question of what rehab program is best for patients to follow after rotator cuff surgery.
We are a long way from publishing standard guidelines for this problem. But you can find some reliable and practical advice in an excellent patient guide called The Patient's Guide to Rotator Cuff Tears available from Medical Multimedia Group also available on-line athttp://www.eorthopod.com/public/.
Keith M. Baumgarten, MD, et al. Rotator Cuff Repair Rehabilitation: A Level I and II Systematic Review. In Sports Health. March/April 2009. Vol. 1. No. 2. Pp. 125-130.
*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.