The effect of postoperative sling immobilization and early mobilization on clinical and functional outcomes after arthroscopic rotator cuff repair: A propensity score-matched analysis

Article type: Research Article

Authors: Misir, Abdulhamit^a | Oguzkaya, Sinan^{b; *} | Kizkapan, Turan Bilge^c | Eken, Gokay^d | Sayer, Gokhan^e

Affiliations: [a] Department of Orthopedics and Traumatology, Istanbul Medicana International Hospital, Istanbul, Turkey | [b] Department of Orthopedics and Traumatology, Cekirge State Hospital, Bursa, Turkey | [c] Department of Orthopedics and Traumatology, Istanbul Basaksehir Pine and Sakura City Training and Research Hospital, Istanbul, Turkey | [d] Department of Orthopedics and Traumatology, Uludag University Medical Faculty, Bursa, Turkey | [e] Department of Orthopedics and Traumatology, Mus State Hospital, Mus, Turkey

Correspondence: [*] Corresponding author: Sinan Oguzkaya, Department of Orthopedics and Traumatology, Sarkisla State Hospital, Sivas, Turkey. E-mail: [email protected].

Abstract: BACKROUND: Optimal postoperative management is controversial after arthroscopic rotator cuff repair (ARCR). OBJECTIVE: The aim of the study was to evaluate outcomes of patients with and without postoperative sling immobilization after undergoing arthroscopic RCR rotator cuff repair. METHOD: 369 arthroscopic full thickness superior rotator cuff tears (RCT) with a minimum follow-up of 6 months were included in this study. Propensity score matching was performed for age, sex, BMI, and tear size. Pain (VAS score), shoulder range of motion (ROM), functional outcome (ASES, Constant-Murley [CM] and Oxford shoulder score [OSS]), and health related quality of life (SF-36) scores were compared between patients with and without sling immobilization. RESULTS: According to the propensity match score, 92 patients (50 sling immobilization and 42 no sling immobilization) were matched to be almost identical in age (62.5 ± 8.0 vs. 61.8 ± 5.9), sex (female 78% vs. 76.2%), BMI (28.1 ± 2.8 vs. 27.8 ± 2.6), and tear size (2.7 ± 1.1 vs. 2.9 ± 0.8). The postoperative physical functioning domain of SF-36 scores was found to be significantly higher in the no sling group (p= 0.034). CONCLUSION: Early mobilization after arthroscopic small and medium sized full thickness superior rotator cuff repair is associated with improved ROM and quality of life scores.

Keywords: Sling, rotator cuff, arthroscopic, function, quality of life

DOI: 10.3233/BMR-210358

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 6, pp. 1391-1398, 2022