Does Early Versus Delayed Active Range of Motion Affect Rotator Cuff Healing After Surgical Repair?: A Systematic Review and Meta-analysis

Background: The timing of passive range of motion (ROM) after surgical repair of the rotator cuff (RC) has been shown to affect healing. However, it is unknown if early or delayed active ROM affects healing. Purpose: To determine whether early versus delayed active ROM affects structural results of RC repair surgery. Study Design: Systematic review and meta-analysis. Methods: A systematic review of articles published between January 2004 and April 2014 was conducted. Structural results were compared for early (3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for suture bridge repairs (48% vs 17.5%; RR, 2.74 [95% CI, 1.59-4.73]) and all repair methods combined (40.5% vs 26.7%; RR, 1.52 [95% CI, 1.17-1.97]). For tears >5 cm, the risk of structural tendon defect was higher in the early versus delayed group for suture bridge repairs (100% vs 16.7%; RR, 6.00 [95% CI, 1.69-21.26]). There were no statistically significant associations for tears measuring ≤1, 1-3, or 3-5 cm. Conclusion: Early active ROM was associated with increased risk of a structural defect for small and large RC tears, and thus might not be advisable after RC repair.