Rehabilitation protocols following rotator cuff repair: a meta‐analysis of current evidence

2021 ◽  
Author(s):  
Udara Bandara ◽  
Vincent V. G. An ◽  
Sahand Imani ◽  
Haren Nandapalan ◽  
Brahman S. Sivakumar
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Meta Analysis ◽  
Current Evidence ◽  
Rehabilitation Protocols ◽  
Cuff Repair

Return to Work After Primary Rotator Cuff Repair: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652097542
Author(s):  
Eric D. Haunschild ◽  
Ron Gilat ◽  
Ophelie Lavoie-Gagne ◽  
Michael C. Fu ◽  
Tracy Tauro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Return To Work ◽  
Rotator Cuff Repair ◽  
Meta Analysis ◽  
Work Outcomes ◽  
Workers Compensation ◽  
Work Intensity ◽  
Rates Of Return ◽  
Cuff Repair

Background: Rotator cuff tears are a prevalent pathology in injured workers, causing significant economic ramifications and time away from work. To date, published articles on work outcomes after rotator cuff repair have not been cumulatively assessed and analyzed. Purpose: To systematically review reports on return to work after rotator cuff repair and perform a meta-analysis on factors associated with improved work outcomes. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review of return-to-work investigations was performed using PubMed, Embase, and the Cochrane Database of Systematic Reviews in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Individual studies reporting rates of return to previous work with level of evidence 1 to 4 were independently screened by 2 authors for inclusion, and study quality was assessed using the Methodologic Index for Non-randomized Studies and Newcastle-Ottawa Scale. Work outcome data were synthesized and analyzed using random effects modeling to identify differences in rates of return to previous work as a function of operative technique, work intensity, and workers’ compensation status. Results: Thirteen retrospective investigations comprising 1224 patients who underwent rotator cuff repair met inclusion criteria for this investigation. Across all investigations, a weighted average of 62.3% of patients returned to previous level of work at 8.15 ± 2.7 months (mean ± SD) after surgery. Based on random effects modeling, higher rates of return to previous work were identified with decreasing work intensity ( P < .001), while rates were similar between open and arthroscopic repair technique ( P = .418) and between workers’ compensation and non–workers’ compensation cohorts ( P = .089). All shoulder pain and functional outcome assessments demonstrated significant improvements at final follow-up when compared with baseline across all investigations. Conclusion: The majority of injured workers undergoing rotator cuff repair return to previous work at approximately 8 months after surgery. Despite this, >35% of patients are unable to return to their previous work level after their repair procedure. Similar rates of return to work can be anticipated regardless of workers’ compensation status and operative technique, while patients in occupations with higher physical intensity experience inferior work outcomes.

scholarly journals Is routine distal clavicle resection necessary in rotator cuff repair surgery? A systematic review and meta-analysis

2017 ◽  
Vol 11 (1_suppl) ◽  
pp. 39-45 ◽  
Author(s):  
Ann Livingstone ◽  
Rafik Asaid ◽  
Afshin Kamali Moaveni
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Analogue Scale ◽  
Meta Analysis ◽  
Distal Clavicle ◽  
Randomized Controlled ◽  
Cuff Repair ◽  
Distal Clavicle Resection

Background The objective of the present study was to perform a systematic review and meta-analysis of randomized controlled trials looking at the effect of distal clavicle resection in patients undergoing rotator cuff repair (RCR). Methods A systematic literature search was undertaken to identify randomized controlled trials looking at RCR +/– distal clavicle resection. Primary clinical outcome measures included in the meta-analysis were American Shoulder Elbow Society (ASES) score, pain on visual analogue scale and range of motion in forward elevation. Results The systematic review identified three studies with a total of 203 participants. Those who underwent distal clavicle resection in conjunction with RCR had worse pain and acromioclavicular joint tenderness at 3-month follow-up. This difference, however, was not observed at the 24-month follow-up. The mean difference (95% confidence interval) for the ASES score was 0.45 (–3.67 to 4.58) and pain on visual analogue scale was – 0.27 (–0.70 to 0.16). Conclusions Routine distal clavicle resection in the setting of rotator cuff repair does not result in improved outcomes for patients with no difference being observed at 24 months post surgery. The results of our systematic review and meta-analysis do not support routine distal clavicle resection when performing RCR.

scholarly journals Effects of arthroscopic vs. mini-open rotator cuff repair on function, pain & range of motion. A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0222953 ◽  
Author(s):  
Goris Nazari ◽  
Joy C. MacDermid ◽  
Dianne Bryant ◽  
Neha Dewan ◽  
George S. Athwal
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Meta Analysis ◽  
Cuff Repair ◽  
Mini Open

The influence of diabetes mellitus on rotator cuff repair: A systematic review and meta-analysis

2020 ◽  
Vol 23 ◽  
Author(s):  
Xiaomin Lu ◽  
He Sun ◽  
YiSheng Xu ◽  
Xuewei Cao
Keyword(s):  
Diabetes Mellitus ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Clinical Studies ◽  
Rotator Cuff Repair ◽  
Meta Analysis ◽  
Japanese Orthopaedic Association ◽  
Cochrane Library ◽  
Significant Difference ◽  
Cuff Repair

Background: : Clinical outcomes after rotator cuff repair associated with diabetes mellitus(DM) are generally favorable, but no study has attempted to establish the influence of DM on outcomes after rotator cuff repair. Purpose: To conduct a meta-analysis of clinical studies evaluating patient outcomes between people with DM and people without DM after rotator cuff repair. Study Design: Meta-analysis. Methods: A literature search of the Embase, PubMed, and Cochrane Library databases was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Cohort studies and case-control studies about clinical outcomes after rotator cuff repair comparing people with DM and people without DM were included. Statistical analysis was performed with RevMan (v 5.3.3). Results: Nine clinical studies that met the inclusion criteria were identified and included a total of 314 patients treated with DM and 1092 patients without DM. The failure rate was significantly higher in the DM group than in Non-DM group (23.97% compared with 16.60%, OR: 2.39; 95% CI, 1.69–3.37; p < 0.001). The postoperative retear rate and showed a significant difference between the two groups (24.5% and 13.7%; OR: 2.41; 95% CI, 1.57–3.71; p<0.001). The DM group showed a higher rate of postoperative unhealed cuff than the Non-DM group(41.81% and 25.23%; OR: 2.14; 95% CI, 1.69–3.37; p=0.01).Postoperative Range of motion(ROM) at 12 months after surgery show a significant difference in the range of external rotation between two groups (WMD: -6.02; 95% CI, -7.54 to -4.50; p<0.001).The preoperative Japanese Orthopaedic Association (JOA) score, the comparison of pre- and post-operative JOA scores showed a significant difference in the DM and Non-DM group(p<0.001). The postoperative JOA score, the pre- and post-operative muscle strength, the pre- and postoperative visual analog scale (VAS) show significant difference between the the DM and Non-DM group(p<0.001). The postoperative infection rates, the rates of postoperative shoulder stiffness, the preoperative ROM, the postoperative ROM at 6 months, the postoperative ROM at 12 months of forward flexion and abduction, the American Shoulder and Elbow Surgeons score, the University of California, Los Angeles scores, and the preoperative Constant-Murley scores show no significant difference between the two groups. Conclusion: This meta-analysis indicates that DM may be relative to a higher rate of shoulder retear and cuff unhealing. However, patients with DM can achieve great clinical outcomes after cuff repair, compared to patients without DM.

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