Rotator cuff injuries: current perspectives and trends for treatment and rehabilitation

An online survey of clinical practice of Brazilian physical therapists on rehabilitation following rotator cuff repair

BACKGROUND

Physical therapy is essential to help patients to recover their movements and function following a rotator cuff repair. However, there are uncertainties regarding how long a sling should be used for and when exercises should be started.

OBJECTIVE

To investigate the current clinical practice of Brazilian physical therapists treating patients who had a rotator cuff repair. We also explored differences between shoulder specialists and non-specialists.

METHODS

An online survey with 38 questions, including a clinical case, regarding the physical therapy clinical practice for patients having a rotator cuff repair.

RESULTS

We analyzed 194 responses. Majority of participants were from the Southeast of Brazil (57.5%), had up to 10 years of clinical experience (61.4%) and were not shoulder-specialists (69.8%). Majority of the respondents stated that patients have their first post-operative physical therapy session within the first three weeks (51%). Patients usually use a sling for four to six weeks (60.6%). Passive mobilization is often started in the first-week post-surgery. Fifteen percent of shoulder specialists compared to only six percent of non-shoulder specialists would allow strengthening exercises to start between the first and third weeks post-surgery.

CONCLUSION

Physical therapists in Brazil seems to follow similar postoperative programs to other countries. Shoulder specialists allow a faster return to activities and start of strengthening exercises.

Arthroscopic rotator cuff repair: single-row vs. double-row - clinical results after one to four years

Objective

Evaluate and compare the results of single-row (SR) vs. double-row (DR) arthroscopic rotator cuff repair.

Methods

From December 2009 to May 2013, 115 arthroscopic rotator cuff repairs were performed using suture anchors. After applying the exclusion criteria, there were 75 patients (79 shoulders) to be evaluated, retrospectively, of whom 53 (56 shoulders) attended re-evaluation. The patients were divided into two groups: SR with 29 shoulders, and DR) with 27 shoulders. The scoring systems for clinical evaluation were those of the University of California at Los Angeles (UCLA) and the American Shoulder and Elbow Surgeons (ASES).

Results

The mean follow-up period in the SR group was 37.8 months vs. 41.0 months in the DR group. The average UCLA score was 30.8 in the SR group vs. 32.6 in the DR group. This difference was not statistically significant (p > 0.05). The averages measured by the ASES score also showed no significant difference – 82.3 and 88.8 in the SR and DR groups, respectively.

Conclusion

No statistically significant difference was found between SR and DR arthroscopic rotator cuff repair performed by a single surgeon in the comparative analysis of UCLA and ASES scores.