Rotator cuff repair protocols: A survey of current New Zealand practice

Abstract

Rehabilitation following surgical rotator cuff repair may enable return to pre-injury function. Optimal recovery is facilitated by the use of post-operative protocols that enhance communication between the surgeon and physiotherapist. The purpose of this study was to describe the rotator cuff repair rehabilitation protocols currently used in New Zealand. Orthopaedic surgeons practising in New Zealand were contacted to determine their current rehabilitation protocols. Length of immobilisation and exercise progression following surgical repair were analysed across weekly timeframes from the day of surgery until nine months post-operatively. The response rate was 55% with protocols received from 31 surgeons. Post-surgical rotator cuff protocols currently in use in New Zealand are predominantly determined by weekly time periods which vary from surgeon to surgeon. Immobilisation was most commonly recommended for four to six weeks, pendular exercises were started the week of surgery, active exercises commenced at six weeks, followed by resisted exercises at twelve weeks. Few protocols based the rehabilitation upon tissue quality and size of rotator cuff tear. Level of detail regarding sets and repetitions of exercises also differed between protocols. Variability across protocols was evident regarding the recommended activity level and time period from surgery. Consideration of tissue quality, size of the tear and strength of the repair is recommended to facilitate optimal results.