• BACKGROUND
    • Arthroscopic rotator cuff repair with biceps re-routing (ABR) has emerged as a reliable option for treating large, posterosuperior rotator cuff tears. This study aims to compare functional and structural outcomes of early versus delayed motion rehabilitation protocols following ABR.
  • METHODS
    • A total of 101 patients with semirigid, large, posterosuperior rotator cuff tears undergoing ABR were randomized into two 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 MRI at a minimum follow-up of 12 months. Statistical analyses were performed to compare outcomes between the two groups.
  • RESULTS
    • Both groups demonstrated significant improvements in VAS score (Group I: 4.0 to 1.6, Group II: 3.7 to 1.4, p = 0.501), UCLA shoulder score (Group I: 21.5 to 31.4, Group II: 22.4 to 30.6, p = 0.331), and acromiohumeral interval (Group I: 8.2 mm to 9.1 mm, Group II: 8.6 mm to 9.5 mm, p = 0.412), 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: 140.1º, Group II: 119.2º, p = 0.006), 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 = 0.826).
  • CONCLUSION
    • This study's findings reveal no clinically discernible differences in active range of motion at one-year follow-up between patients who underwent ABR for semirigid, large, posterosuperior rotator cuff tears and were assigned to either early or delayed motion protocols. Notably, the early motion group demonstrated a plateau in maximum ROM improvement as early as three months post-surgery. Based on these results, implementing an early motion protocol is recommended as an effective approach in the postoperative rehabilitation following ABR.