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No sling after rotator cuff repair may yield better early mobility, functional scores
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Patients who did not use a sling after arthroscopic repair of a small or medium superior rotator cuff tear experienced better early mobility and functional scores compared with patients who used a sling, according to published results.
Researchers randomly assigned 80 patients undergoing arthroscopic repair of a small or medium superior rotator cuff tear to either use a sling or not postoperatively. Both groups performed passive mobilization during the first 4 postoperative weeks followed by progressive active mobilization. Researchers evaluated patients clinically at 10 days, 1.5 months, 3 months and 6 months and by using ultrasound at 6 months. To determine if postoperative scores were associated with sex, age at surgery, immobilization, arm dominance, a biceps procedure, resection of the distal part of the clavicle or preoperative scores, researchers performed univariable and multivariable analyses.
Results showed similar preoperative patient characteristics, function and adjuvant procedures, as well as no differences in pain at 10 days, between the two groups. Researchers found greater mean external rotation and active elevation at 1.5 months and better mean active elevation and internal rotation at 3 months in the no-sling group. However, the two groups had no significant differences in tendon thickness anteriorly or posteriorly, bursitis, echogenicity or repair integrity found with ultrasound evaluation at 6 months. Through multivariable analyses, researchers noted an increase in mean American Shoulder and Elbow Surgeons score with patient age, a decrease in the single assessment numeric evaluation with sling immobilization and an increase in pain with sling immobilization.
“Postoperative immobilization with a sling may therefore not be required for patients treated for a small or medium tendon tear,” the authors wrote.– by Casey Tingle
Disclosures: The researchers report no relevant financial disclosures.
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