Arthroscopic rotator cuff repair: comparing postoperative treatment options for pain

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The average level of pain measured directly postoperation up to 1 year after surgery was not significant different between treatment groups.
The average level of pain measured directly postoperation up to 1 year after surgery was not significant different between treatment groups.

For short-term treatment after arthroscopic rotator cuff repair (ARCR), no significant difference occurred between the use of an abduction brace vs an antirotation sling in the level of pain, function, and quality of life, according to a study published in Arthroscopy.  

Freek Hollman, MD, from Department of Orthopaedic Surgery at St. Antonius Hospital in the Netherlands, and colleagues conducted a randomized controlled trial of patients recruited from October 2012 through January 2014. Patients were eligible if they were between the ages of 18 and 75 years with a diagnosis of a traumatic or degenerative tear of the supraspinatus and/or infraspinatus tendon and received an arthroscopic footprint repair. Postoperative pain and use of analgesics were recorded up to 3 months after surgery using a patient diary. Measuring points were preoperative, twice daily after surgery during the first week, and thereafter weekly. Pain was recorded at rest and during activities.

After 6 weeks, 3 months, 6 months, and 1 year, the patients visited the outpatient orthopedic department for functional assessment and administration of several questionnaires, including Constant-Murley score, Western Ontario Rotator Cuff index, and glenohumeral range of motion.

A total of 36 patients were included (mean age, 61.2 years). Fifty percent of the patients were right-handed, with a mean duration of symptoms before surgery of 16.3 months. The average level of pain measured directly postoperation up to 1 year after surgery was not significant different between groups. Postoperatively, function scores and glenohumeral range of motion improved significantly for both groups. No retears were observed on ultrasonograph 3 months after surgery.

“No significant differences were found between patients receiving an abduction brace or antirotation sling for shoulder immobilization after ARCR with respect to the pre-established primary outcome (pain) and secondary outcome measurements,” concluded the authors.

Reference

Hollman F, Wolterbeek N, Zijl JAC, et al. Abduction brace versus antirotation sling after arthroscopic cuff repair: The effects on pain and function. Arthroscopy. 2017 Sep;33(9). doi: 10.1016/j.arthro.2017.02.010.

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