This study compared the clinical outcomes following mini-open rotator cuff repair (MORCR) between early mobilisation and usual care, involving initial immobilisation. In total, 189 patients with radiologically-confirmed full-thickness rotator cuff tears underwent MORCR and were randomised to either early mobilisation (n = 97) or standard rehabilitation (n = 92) groups. Patients were assessed at six weeks and three, six, 12 and 24 months post-operatively. Six-week range of movement comparisons demonstrated significantly increased abduction (p = 0.002) and scapular plane elevation (p = 0.006) in the early mobilisation group, an effect which was not detectable at three months (p > 0.51) or afterwards. At 24 months post-operatively, patients who performed pain-free, early active mobilisation for activities of daily living showed no difference in clinical outcomes from patients immobilised for six weeks following MORCR. We suggest that the choice of rehabilitation regime following MORCR may be left to the discretion of the patient and the treating surgeon.

Cite this article: Bone Joint J 2015;97-B:1257–63.

Purpose: Arthroscopic stabilization for post-traumatic anterior glenohumeral instability is designed to minimize soft tissue dissection while achieving similar or improved outcomes relative to open techniques. This study’s purpose was to determine the rate of post-operative recurrent instability and evaluate health related quality of life (HRQL) and shoulder range of motion (ROM) following arthroscopic Bankart repair using a bioabsorbable knotless implant.

Method: Forty-three patients were prospectively evaluated following arthroscopic anterior stabilization to assess for recurrent instability, HRQL, and shoulder ROM. Assessments were performed pre-operatively and 3, 6 and 12–24 months postoperatively. The HRQL measures included the Western Ontario Shoulder Instability Index (WOSI), the American Shoulder and Elbow Surgeons Score (ASES), and the Constant Score. Repeated measures ANOVA was utilized to evaluate ROM and HRQL.

Results: The mean WOSI score improved from 45.67±17.99 pre-operatively to 83.16±18.58 at final follow-up. The mean ASES scores improved from 80.1±13.06 pre-operatively to 92.25±15.08, while the Constant score improved from 77.52±16.11 pre-operatively to 85.18±26.76. At final follow-up, 4 of 43 patients (9.3%) had experienced recurrent instability. For these 4 subjects, the WOSI score was significantly lower at final follow-up than those who did not experience recurrent instability (61.73±5.76 versus 84.38±16.94). The ASES and Constant scores at final follow-up were not significantly different between these two groups.

Conclusion: Arthroscopic anterior stabilization using a bioabsorable tack led to a recurrent instability rate similar to previous reports, and resulted in improved HRQL and shoulder ROM. The WOSI score was better able to detect problems in HRQL related to instability than either the ASES or Constant score.