Abstract：
BACKGROUND: Arthroscopic rotator cuff repair with biceps rerouting (ABR) has emerged as a reliable option for treating large posterosuperior rotator cuff tears (RCTs). This study aims to compare functional and structural outcomes of early vs. delayed motion rehabilitation protocols following ABR.
METHODS: A total of 101 patients with semirigid, large, posterosuperior RCTs undergoing ABR were randomized into 2 groups: group I (early motion) with 53 patients (34 females, 19 males) and group II (delayed motion) with 48 patients (31 females, 17 males). In group I, the mean age was 63.9 years (range, 46-79), and in group II, it was 65.4 years (range, 43-78). The mean follow-up periods for group I and group II were 16.2 and 15.5 months, respectively. Preoperative and postoperative assessments were conducted at 3, 6, and 12 months, with structural integrity assessed with magnetic resonance imaging at a minimum follow-up of 12 months. Statistical analyses were performed to compare outcomes between the 2 groups.
RESULTS: Both groups demonstrated significant improvements in visual analog scale score (group I: 4.0-1.6, group II: 3.7-1.4, P = .501), University of California-Los Angeles shoulder score (group I: 21.5-31.4, group II: 22.4-30.6, P = .331), and acromiohumeral interval (group I: 8.2 mm-9.1 mm, group II: 8.6 mm-9.5 mm, P = .412), with no statistically or clinically meaningful differences. Active range of movements (ROM) were not significantly different between groups, except for active forward flexion at 3 months (group I: 140.1°, group II: 119.2°, P = .006), that was not shown to be translated clinically into differences in function or healing between the groups in this study. Notably, retear rates were similar between groups (group I: 22.6%, group II: 20.8%, P = .826).
CONCLUSIONS: This study\'s findings reveal no clinically discernible differences in active range of motion at 1-year follow-up between patients who underwent ABR for semirigid, large, posterosuperior RCTs and were assigned to either early or delayed motion protocols. Notably, the early motion group demonstrated a plateau in maximum range of movement improvement as early as 3 months postsurgery. Based on these results, implementing an early motion protocol is recommended as an effective approach in the postoperative rehabilitation following ABR.
METHODS: A total of 101 patients with semirigid, large, posterosuperior RCTs undergoing ABR were randomized into 2 groups: group I (early motion) with 53 patients (34 females, 19 males) and group II (delayed motion) with 48 patients (31 females, 17 males). In group I, the mean age was 63.9 years (range, 46-79), and in group II, it was 65.4 years (range, 43-78). The mean follow-up periods for group I and group II were 16.2 and 15.5 months, respectively. Preoperative and postoperative assessments were conducted at 3, 6, and 12 months, with structural integrity assessed with magnetic resonance imaging at a minimum follow-up of 12 months. Statistical analyses were performed to compare outcomes between the 2 groups.
RESULTS: Both groups demonstrated significant improvements in visual analog scale score (group I: 4.0-1.6, group II: 3.7-1.4, P = .501), University of California-Los Angeles shoulder score (group I: 21.5-31.4, group II: 22.4-30.6, P = .331), and acromiohumeral interval (group I: 8.2 mm-9.1 mm, group II: 8.6 mm-9.5 mm, P = .412), with no statistically or clinically meaningful differences. Active range of movements (ROM) were not significantly different between groups, except for active forward flexion at 3 months (group I: 140.1°, group II: 119.2°, P = .006), that was not shown to be translated clinically into differences in function or healing between the groups in this study. Notably, retear rates were similar between groups (group I: 22.6%, group II: 20.8%, P = .826).
CONCLUSIONS: This study\'s findings reveal no clinically discernible differences in active range of motion at 1-year follow-up between patients who underwent ABR for semirigid, large, posterosuperior RCTs and were assigned to either early or delayed motion protocols. Notably, the early motion group demonstrated a plateau in maximum range of movement improvement as early as 3 months postsurgery. Based on these results, implementing an early motion protocol is recommended as an effective approach in the postoperative rehabilitation following ABR.
摘要：
背景：使用二头肌重新布线（ABR）进行关节镜肩袖修复已成为治疗大型，后上肩袖撕裂。这项研究旨在比较ABR后早期与延迟运动康复方案的功能和结构结果。
方法：共101例半刚性，大,接受ABR的后上肩袖撕裂被随机分为两组：第一组（早期运动）53例患者（34例女性，19名男性）和II组（延迟运动），48名患者（31名女性，17名男性）。在第一组中,平均年龄为63.9岁(范围，46-79),在第二组中，这是65.4年(范围，43-78).第一组和第二组的平均随访时间为16.2和15.5个月，分别。术前和术后评估分别在3、6和12个月进行。至少随访12个月，用MRI评估结构完整性。进行统计分析以比较两组之间的结果。
结果：两组均表现出VAS评分的显着改善（I组：4.0至1.6，II组：3.7至1.4，p=0.501），加州大学洛杉矶分校肩部评分（第一组：21.5至31.4，第二组：22.4至30.6，p=0.331），和肩眼间隔（I组：8.2mm至9.1mm，第二组：8.6毫米至9.5毫米，p=0.412)，没有统计学或临床意义的差异。活动范围（ROM）在组间没有显著差异，除了3个月时的主动前屈（第一组：140.1º，第二组：119.2º，p=0.006),在这项研究中，没有显示出临床上可以转化为两组之间功能或愈合的差异。值得注意的是,两组之间的再撕裂率相似(第一组：22.6%，第二组:20.8%,p=0.826)。
结论：这项研究的发现表明，在接受半刚性ABR的患者之间，在一年的随访中，主动运动范围没有临床上明显的差异，大,后上肩袖撕裂，并被分配到早期或延迟运动方案。值得注意的是,早期运动组早在术后3个月时就显示出最大ROM改善的平台期.基于这些结果,建议实施早期运动方案作为ABR术后康复的有效方法.
方法：共101例半刚性，大,接受ABR的后上肩袖撕裂被随机分为两组：第一组（早期运动）53例患者（34例女性，19名男性）和II组（延迟运动），48名患者（31名女性，17名男性）。在第一组中,平均年龄为63.9岁(范围，46-79),在第二组中，这是65.4年(范围，43-78).第一组和第二组的平均随访时间为16.2和15.5个月，分别。术前和术后评估分别在3、6和12个月进行。至少随访12个月，用MRI评估结构完整性。进行统计分析以比较两组之间的结果。
结果：两组均表现出VAS评分的显着改善（I组：4.0至1.6，II组：3.7至1.4，p=0.501），加州大学洛杉矶分校肩部评分（第一组：21.5至31.4，第二组：22.4至30.6，p=0.331），和肩眼间隔（I组：8.2mm至9.1mm，第二组：8.6毫米至9.5毫米，p=0.412)，没有统计学或临床意义的差异。活动范围（ROM）在组间没有显著差异，除了3个月时的主动前屈（第一组：140.1º，第二组：119.2º，p=0.006),在这项研究中，没有显示出临床上可以转化为两组之间功能或愈合的差异。值得注意的是,两组之间的再撕裂率相似(第一组：22.6%，第二组:20.8%,p=0.826)。
结论：这项研究的发现表明，在接受半刚性ABR的患者之间，在一年的随访中，主动运动范围没有临床上明显的差异，大,后上肩袖撕裂，并被分配到早期或延迟运动方案。值得注意的是,早期运动组早在术后3个月时就显示出最大ROM改善的平台期.基于这些结果,建议实施早期运动方案作为ABR术后康复的有效方法.
