A Level I randomized trial comparing early (postoperative day 2) versus delayed (6-week) passive range of motion after arthroscopic repair of isolated full-thickness supraspinatus tears. All repairs used a transosseous-equivalent suture-bridge technique with subacromial decompression. It asks whether protecting the repair by delaying motion improves healing without sacrificing final function.
The clinical rule here: for an isolated, crescent-shaped full-thickness supraspinatus tear repaired arthroscopically, you can safely delay formal passive motion to 6 weeks without hurting 1-year function.
The biological rationale matters for boards. At 4 weeks the repair is histologically immature, and even passive elevation fires the cuff and strains the repair. Animal models show immobilization enhances tendon-to-bone healing. Early motion still has a role: it restored elevation faster at 6 months. So the tradeoff is early speed versus repair protection, with equal endpoints either way.
Practical bonus: delaying therapy spared patients roughly 15 outpatient sessions each, a real cost savings. Critical caveat for appraisal: the study was underpowered for healing (138 per group needed), so the 91% vs 85% trend cannot be called a true difference. Applies only to small isolated supraspinatus tears, not large or retracted tears.
A Level I randomized trial comparing early (postoperative day 2) versus delayed (6-week) passive range of motion after arthroscopic repair of isolated full-thickness supraspinatus tears. All repairs used a transosseous-equivalent suture-bridge technique with subacromial decompression. It asks whether protecting the repair by delaying motion improves healing without sacrificing final function.
The clinical rule here: for an isolated, crescent-shaped full-thickness supraspinatus tear repaired arthroscopically, you can safely delay formal passive motion to 6 weeks without hurting 1-year function.
The biological rationale matters for boards. At 4 weeks the repair is histologically immature, and even passive elevation fires the cuff and strains the repair. Animal models show immobilization enhances tendon-to-bone healing. Early motion still has a role: it restored elevation faster at 6 months. So the tradeoff is early speed versus repair protection, with equal endpoints either way.
Practical bonus: delaying therapy spared patients roughly 15 outpatient sessions each, a real cost savings. Critical caveat for appraisal: the study was underpowered for healing (138 per group needed), so the 91% vs 85% trend cannot be called a true difference. Applies only to small isolated supraspinatus tears, not large or retracted tears.