title: Does immobilization after arthroscopic rotator cuff repair increase tendon healing? A systematic review and meta-analysis.
abstract: BACKGROUND
  To determine whether immobilization after arthroscopic rotator cuff repair improved tendon healing compared with early passive motion.
  
  
  METHODS
  A systematic electronic literature search was conducted to identify randomized controlled trials (RCTs) comparing early passive motion with immobilization after arthroscopic rotator cuff repair. The primary outcome assessed was tendon healing in the repaired cuff. Secondary outcome measures were range of motion (ROM) and American Shoulder and Elbow Surgeons (ASES) shoulder scale, Simple Shoulder Test (SST), Constant, and visual analog scale (VAS) for pain scores. Pooled analyses were performed using a random effects model to obtain summary estimates of treatment effect with 95% confidence intervals. Heterogeneity among included studies was quantified.
  
  
  RESULTS
  Three RCTs examining 265 patients were included. Meta-analysis revealed no significant difference in tendon healing in the repaired cuff between the early-motion and immobilization groups. A significant difference in external rotation at 6 months postoperatively favored early motion over immobilization, but no significant difference was observed at 1 year postoperatively. In one study, Constant scores were slightly higher in the early-motion group than in the immobilization group. Two studies found no significant difference in ASES, SST, or VAS score between groups.
  
  
  CONCLUSIONS
  We found no evidence that immobilization after arthroscopic rotator cuff repair was superior to early-motion rehabilitation in terms of tendon healing or clinical outcome. Patients in the early-motion group may recover ROM more rapidly.
  
  
  METHODS
  Level II; systematic review of levels I and II studies.
authors.affiliation: Department of Orthopedics, The Affiliated Hospital of Guilin Medical College, Guilin, 541001, Guangxi, China, sc821@foxmail.com.
authors.forename: Chong
authors.initials: C
authors.lastname: Shen
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Tang
authors.forename: Jun-Zu
authors.initials: JZ
authors.lastname: Hu
authors.forename: Guo-Yao
authors.initials: GY
authors.lastname: Zou
authors.forename: Rong-Chi
authors.initials: RC
authors.lastname: Xiao
authors.forename: Dong-Xue
authors.initials: DX
authors.lastname: Yan
mesh_terms: D001182:Arthroscopy / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D007103:Immobilization; D015233:Models, Statistical; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods*; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology / Q000601:surgery; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing