title: Effect of immobilization without passive exercise after rotator cuff repair: randomized clinical trial comparing four and eight weeks of immobilization.
abstract: BACKGROUND
  While animal studies have shown better healing with a longer duration of protection without motion exercise after rotator cuff repair, supporting clinical studies are rare. The purpose of this study was to assess the effect of immobilization following rotator cuff repair and to determine whether there was any difference in clinical outcome related to the duration of immobilization.
  
  
  METHODS
  One hundred patients who underwent arthroscopic single-row repair of a posterosuperior rotator cuff tear (mean, 2.3 cm in the coronal-oblique plane and 2.0 cm in the sagittal-oblique plane) were prospectively randomized to be treated with immobilization for four or eight weeks. During the immobilization period, no passive or active range-of-motion exercise, including pendulum exercise, was allowed. According to the intention-to-treat protocol and full analysis set, eighty-eight patients were evaluated clinically and with magnetic resonance imaging postoperatively, after exclusion of twelve patients without postoperative clinical evaluation. Ranges of motion, clinical scores, and retear rates were compared between the four and eight-week groups. Ninety-eight patients were contacted by telephone at a mean of thirty-five months to investigate the clinical outcomes.
  
  
  RESULTS
  The mean duration of immobilization was 4.1 weeks in the four-week group and 7.3 weeks in the eight-week group. There were nine full-thickness retears (10%), and 89% of the patients rated their result as excellent or good. There were five full-thickness retears in the four-week group and four in the eight-week group (p = 0.726). At the time of final follow-up, the two groups showed no differences in range of motion or clinical scores. However, the proportion showing stiffness was higher in the eight-week group (38% compared with 18%, p = 0.038).
  
  
  CONCLUSIONS
  Eight weeks of immobilization did not yield a higher rate of healing of medium-sized rotator cuff tears compared with four weeks of immobilization.
authors.affiliation: Department of Orthopaedic Surgery, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 131-130, South Korea. E-mail address: osdoc.koh@gmail.com.
authors.forename: Kyoung Hwan
authors.initials: KH
authors.lastname: Koh
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, 1126-1 Sanbon-dong, Gunpo-si, Gyeonggi-do 435-040, South Korea.
authors.forename: Tae Kang
authors.initials: TK
authors.lastname: Lim
authors.affiliation: Department of Orthopaedic Surgery, National Medical Center, 245 Euljiro, jung-gu, Seoul 100-799, South Korea.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Shon
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. E-mail address for J.C. Yoo: shoulderyoo@gmail.com.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. E-mail address for J.C. Yoo: shoulderyoo@gmail.com.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. E-mail address for J.C. Yoo: shoulderyoo@gmail.com.
authors.forename: Jae Chul
authors.initials: JC
authors.lastname: Yoo
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology