Rehabilitation following rotator cuff repair: A survey exploring clinical equipoise among surgical members of the British Elbow and Shoulder Society

Mazuquin, Bruno; Bateman, Marcus; Realpe, Alba; Drew, Steve; Rees, Jonathan; Littlewood, Chris

Abstract

Background: We investigated clinical equipoise across surgical members of the British Elbow and Shoulder Society (BESS) in relation to rehabilitation following rotator cuff repair.

Method: An online survey explored clinical equipoise regarding early patient-directed versus standard rehabilitation after rotator cuff repair to inform the design of a national randomised controlled trial (RCT). It described different clinical scenarios relating to patient age, tear size, location and whether other patient-related and intra-operative factors would influence equipoise.

Results: 76 surgeons completed the survey. 81% agreed/ strongly agreed that early mobilisation might benefit recovery; 57% were neutral/ disagreed that this approach risks re-tear. 87% agreed/ strongly agreed that there is clinical uncertainty about the effectiveness of different approaches to rehabilitation. As age of the patient and tear size increased, the proportion of respondents who would agree to recruit and accept the outcome of randomisation reduced, and this was compounded if subscapularis was torn. Other factors that influenced equipoise were diabetes and non-secure repair.

Conclusion: Surgical members of BESS recognise uncertainty about the effectiveness of different approaches to rehabilitation following rotator cuff repair. We identified a range of factors that influence clinical equipoise that will be considered in the design of a new RCT.

Citation

Mazuquin, B., Bateman, M., Realpe, A., Drew, S., Rees, J., & Littlewood, C. (2021). Rehabilitation following rotator cuff repair: A survey exploring clinical equipoise among surgical members of the British Elbow and Shoulder Society. Shoulder and Elbow, 14(5), 568-573. https://doi.org/10.1177/17585732211059804

• Journal Article Type: Article
• Acceptance Date: Oct 26, 2021
• Online Publication Date: Dec 1, 2021
• Publication Date: Dec 1, 2021
• Deposit Date: Nov 18, 2024
• Publicly Available Date: Nov 21, 2024
• Journal: Shoulder & Elbow
• Print ISSN: 1758-5732
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 5
• Pages: 568-573
• DOI: https://doi.org/10.1177/17585732211059804
• Keywords: rotator cuff repair, rehabilitation, survey, equipoise