In 2012, a study has investigated the impact of early versus delayed postoperative physical therapy on patient outcomes and rotator cuff healing following arthroscopic rotator cuff repair. Conducted by Derek J. Cuff and Derek R. Pupello, the research focused on whether the timing of passive motion exercises influences recovery and tissue healing.

The study enrolled 68 patients, with an average age of 63.2 years, all of whom had full-thickness crescent-shaped tears of the supraspinatus muscle. The tears were repaired using a transosseous equivalent suture-bridge technique accompanied by subacromial decompression. Patients were randomly assigned to one of two groups:

• Early Therapy Group: 33 patients began passive elevation and rotation exercises on the second day after surgery.
• Delayed Therapy Group: 35 patients started the same exercises six weeks post-surgery.

All patients were monitored clinically for at least 12 months, with rotator cuff healing assessed through ultrasound imaging.

The results revealed no significant differences between the two groups in terms of clinical outcomes and patient satisfaction. Both groups showed substantial improvements from preoperative to postoperative assessments:

• American Shoulder and Elbow Surgeons (ASES) Scores:
  • Early group: from 43.9 to 91.9
  • Delayed group: from 41.0 to 92.8
• Simple Shoulder Test (SST) Scores:
  • Early group: from 5.5 to 11.1
  • Delayed group: from 5.1 to 11.1

Patients in both groups expressed similar levels of satisfaction with their recovery and achieved comparable ranges of motion at the one-year mark. However, the delayed therapy group exhibited a slightly higher rate of rotator cuff healing (91%) compared to the early therapy group (85%).

The study concluded that both early and delayed postoperative physical therapy protocols yield very similar patient outcomes and range of motion after one year. The marginally higher healing rate observed in the delayed group suggests a potential benefit of postponing passive motion exercises, although the difference was not statistically significant.

This research provides valuable insights for orthopedic surgeons and physical therapists in optimizing postoperative care for patients undergoing arthroscopic rotator cuff repair. Further studies may help to refine these protocols to enhance healing and functional recovery.

Reference: Cuff, D. J., & Pupello, D. R. (2012). Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol. Journal of shoulder and elbow surgery, 21(11), 1450-1455.