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The optimal rehabilitation protocol after rotator cuff repair remains debated because early motion may reduce stiffness while excessive loading could compromise healing. This randomized trial compared early range of motion with a six-week immobilization protocol after arthroscopic repair of small full-thickness tears. Clinical outcomes, pain and strength were followed for two years, and tendon integrity was assessed with ultrasound. The study found no important long-term differences in function or repair integrity between the protocols, while early motion provided faster recovery of movement. The findings support the use of a more flexible rehabilitation pathway for selected small tears, provided movement is controlled and does not overload the repair. For HCPs, the key point is to match rehabilitation intensity to the biological and mechanical risk of the tear. Larger tears, poor tissue quality or revision surgery may justify slower progression. A one-size-fits-all protocol is less defensible than a risk-adapted approach that aims to minimise stiffness without sacrificing tendon healing.
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The optimal rehabilitation protocol after rotator cuff repair remains debated because early motion may reduce stiffness while excessive loading could compromise healing. This randomized trial compared early range of motion with a six-week immobilization protocol after arthroscopic repair of small full-thickness tears. Clinical outcomes, pain and strength were followed for two years, and tendon integrity was assessed with ultrasound. The study found no important long-term differences in function or repair integrity between the protocols, while early motion provided faster recovery of movement. The findings support the use of a more flexible rehabilitation pathway for selected small tears, provided movement is controlled and does not overload the repair. For HCPs, the key point is to match rehabilitation intensity to the biological and mechanical risk of the tear. Larger tears, poor tissue quality or revision surgery may justify slower progression. A one-size-fits-all protocol is less defensible than a risk-adapted approach that aims to minimise stiffness without sacrificing tendon healing.
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