Maher Natasha, Willmore Elaine, Bateman Marcus, Blacknall James, Chester Rachel, Horsley Ian, Gibson Jo, O' Sullivan Joel, Jaggi Anju
MSK Department, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK.
Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
Shoulder Elbow. 2024 Feb;16(1):85-97. doi: 10.1177/17585732231154889. Epub 2023 Feb 10.
Optimal rehabilitation following arthroscopic shoulder stabilisation for traumatic anterior instability is unknown. The purpose of this study was to establish current UK practice for this patient group.
A self-administered online questionnaire was developed and distributed to UK surgeons and physiotherapists.
138 responses were received. Routine immobilisation was reported in 79.7% of responses with a cross-body sling being the preferred position (63.4%). Duration of immobilisation and timescales to initiate movement were highly variable. Return to light work was advised when patients felt able (25.4%) or after 6 weeks (26.1%). 58.7% recommended waiting for 12 weeks to return to manual work. 56% recommended non-contact sport could be resumed after 12 weeks. For contact sport, recommendations varied from 6 weeks (3.8%) to 6 months (5.8%). Psychological readiness was the most frequently cited criteria for return to play (58.6%). Factors such as hyperlaxity (40.6%), age (32.6%) and kinesiophobia (28.3%) were not considered as relevant as reported quality of surgical fixation (50%).
There is no clear consensus regarding optimal post-operative rehabilitation following arthroscopic shoulder stabilisation. Further work is required to establish high value, personalised pathways for this patient group.
创伤性前向不稳肩关节镜下稳定修复术后的最佳康复方案尚不清楚。本研究旨在确立英国针对该患者群体的当前治疗方法。
设计了一份在线自填问卷，并分发给英国的外科医生和物理治疗师。
共收到138份回复。79.7%的回复报告了常规制动，其中患侧上肢交叉悬吊于胸前是首选姿势（63.4%）。制动时间和开始活动的时间尺度差异很大。建议患者感觉可以时（25.4%）或6周后（26.1%）恢复轻体力工作。58.7%建议等待12周后恢复体力工作。56%建议12周后可恢复非接触性运动。对于接触性运动，建议时间从6周（3.8%）到6个月（5.8%）不等。心理准备是最常被提及的恢复运动标准（58.6%）。诸如关节过度松弛（40.6%）、年龄（32.6%）和运动恐惧症（28.3%）等因素，被认为不如报告的手术固定质量（50%）相关。
关于关节镜下肩关节稳定修复术后的最佳术后康复方案，目前尚无明确共识。需要进一步开展工作，为该患者群体建立高价值的个性化康复路径。
