Nikolaidou Ourania, Migkou Stefania, Karampalis Christos
Physical and Rehabilitation Medicine, B' Orthopaedic Department, 424 General Army Hospital, Thessaloniki, Greece.
Open Orthop J. 2017 Feb 28;11:154-162. doi: 10.2174/1874325001711010154. eCollection 2017.
Rotator cuff tears are a very common condition that is often incapacitating. Whether non-surgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. If conservative management is insufficient, surgical repair is often indicated. Postsurgical outcomes for patients having had rotator cuff repair can be quite good. A successful outcome is much dependent on surgical technique as it is on rehabilitation. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on clinical experience and expert opinion. This article describes the different rehabilitation protocols that aim to protect the repair in the immediate postoperative period, minimize postoperative stiffness and muscle atrophy.
A review of currently available literature on rehabilitation after arthroscopic rotator cuff tear repair was performed to illustrate the available evidence behind various postoperative treatment modalities.
There were no statistically significant differences between a conservative and an accelerated rehabilitation protocol . Early passive range of motion (ROM) following arthroscopic cuff repair is thought to decrease postoperative stiffness and improve functionality. However, early aggressive rehabilitation may compromise repair integrity.
The currently available literature did not identify any significant differences in functional outcomes and relative risks of re-tears between delayed and early motion in patients undergoing arthroscopic rotator cuff repairs. A gentle rehabilitation protocol with limits in range of motion and exercise times after arthroscopic rotator cuff repair would be better for tendon healing without taking any substantial risks. A close communication between the surgeon, the patient and the physical therapy team is important and should continue throughout the whole recovery process.
肩袖撕裂是一种非常常见的疾病，常导致功能丧失。无论是非手术治疗还是手术治疗，肩袖疾病的成功管理都依赖于适当的康复治疗。如果保守治疗不足，通常需要进行手术修复。肩袖修复术后患者的手术效果通常较好。成功的手术效果很大程度上取决于手术技术和康复治疗。许多用于管理肩袖疾病的康复方案主要基于临床经验和专家意见。本文介绍了不同的康复方案，旨在在术后即刻保护修复部位，最大限度地减少术后僵硬和肌肉萎缩。
对目前关于关节镜下肩袖撕裂修复术后康复的现有文献进行综述，以阐明各种术后治疗方式背后的现有证据。
保守康复方案和加速康复方案之间没有统计学上的显著差异。关节镜下肩袖修复术后早期被动活动范围（ROM）被认为可减少术后僵硬并改善功能。然而，早期积极的康复可能会损害修复的完整性。
目前的现有文献并未发现关节镜下肩袖修复患者延迟活动和早期活动在功能结果和再次撕裂的相对风险方面存在任何显著差异。关节镜下肩袖修复术后采用温和的康复方案，限制活动范围和锻炼时间，对肌腱愈合更好，且不会带来任何重大风险。外科医生、患者和物理治疗团队之间的密切沟通很重要，并且应在整个恢复过程中持续进行。
