PDF(Pubmed)
Abstract：
OBJECTIVE: Arthroscopy has become increasingly popular for a addressing a wide variety of shoulder pathology. However, despite increasing interest, there is still much uncertainty and variability amongst providers regarding optimal post-operative rehabilitation. This review provides an overview of the evidence underlying common rehab protocols used following arthroscopic interventions for rotator cuff disease, shoulder instability, superior labral anterior to posterior (SLAP) tears and adhesive capsulitis.
RESULTS: For small and medium sized rotator cuff tears, early motion protocols do not seem to affect healing or retear rates, however there is no difference with regards to long term functional outcomes when compared to standard motion protocols. For larger tears (> 3 cm), early active motion may be associated with impaired tendon integrity. Early range of motion following arthroscopic Bankart repair has not been shown to increase rate of recurrence, however the data on return to sport requires more granularity to effectively guide care. Further research needs to be done to compare rehab protocols following SLAP repair and arthroscopic capsular release. Rehabilitation protocols following rotator cuff surgery and anterior shoulder stabilization have garnered the most research interest. However, there is still a need for larger higher-level studies examining the long-term effects of different rehab protocols. Regarding the arthroscopic management of other types of shoulder instability, SLAP tears and adhesive capsulitis, there is paucity of high-quality evidence. This knowledge gap likely underpins the variability in different rehab protocols seen in clinical practice, highlighting the need for more research.
RESULTS: For small and medium sized rotator cuff tears, early motion protocols do not seem to affect healing or retear rates, however there is no difference with regards to long term functional outcomes when compared to standard motion protocols. For larger tears (> 3 cm), early active motion may be associated with impaired tendon integrity. Early range of motion following arthroscopic Bankart repair has not been shown to increase rate of recurrence, however the data on return to sport requires more granularity to effectively guide care. Further research needs to be done to compare rehab protocols following SLAP repair and arthroscopic capsular release. Rehabilitation protocols following rotator cuff surgery and anterior shoulder stabilization have garnered the most research interest. However, there is still a need for larger higher-level studies examining the long-term effects of different rehab protocols. Regarding the arthroscopic management of other types of shoulder instability, SLAP tears and adhesive capsulitis, there is paucity of high-quality evidence. This knowledge gap likely underpins the variability in different rehab protocols seen in clinical practice, highlighting the need for more research.
摘要：
目的：关节镜检查已成为越来越受欢迎的治疗广泛的肩关节病理。然而,尽管兴趣越来越大，对于最佳的术后康复，提供者之间仍然存在很多不确定性和可变性。这篇综述概述了肩袖疾病关节镜干预后使用的常见康复方案的基础证据。肩部不稳定,上唇前后（SLAP）撕裂和粘连性囊炎。
结果：对于中小型肩袖撕裂，早期运动方案似乎不影响愈合或再撕裂率，然而,与标准运动方案相比,在长期功能结局方面没有差异.对于较大的眼泪（>3厘米），早期主动运动可能与受损的肌腱完整性有关。关节镜Bankart修复后的早期活动范围并未显示出增加复发率，然而，重返运动的数据需要更多的粒度来有效地指导护理。需要进行进一步的研究以比较SLAP修复和关节镜囊释放后的康复方案。肩袖手术和肩前稳定后的康复方案引起了最多的研究兴趣。然而,仍然需要更大规模的更高层次的研究来检查不同康复方案的长期影响。关于其他类型肩关节不稳定的关节镜治疗，SLAP撕裂和粘连性囊炎,缺乏高质量的证据。这种知识差距可能是临床实践中看到的不同康复方案的可变性的基础。强调需要更多的研究。
结果：对于中小型肩袖撕裂，早期运动方案似乎不影响愈合或再撕裂率，然而,与标准运动方案相比,在长期功能结局方面没有差异.对于较大的眼泪（>3厘米），早期主动运动可能与受损的肌腱完整性有关。关节镜Bankart修复后的早期活动范围并未显示出增加复发率，然而，重返运动的数据需要更多的粒度来有效地指导护理。需要进行进一步的研究以比较SLAP修复和关节镜囊释放后的康复方案。肩袖手术和肩前稳定后的康复方案引起了最多的研究兴趣。然而,仍然需要更大规模的更高层次的研究来检查不同康复方案的长期影响。关于其他类型肩关节不稳定的关节镜治疗，SLAP撕裂和粘连性囊炎,缺乏高质量的证据。这种知识差距可能是临床实践中看到的不同康复方案的可变性的基础。强调需要更多的研究。
