Purpose: To screen manuscripts that discuss rehabilitation protocols for patients who underwent superior capsular reconstruction (SCR) to elucidate whether a standard rehabilitation algorithm exists for SCR. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (i.e., PRISMA) guidelines. PubMed (MEDLINE) and Embase were searched using pertinent Boolean operation terms "superior capsular reconstruction" and "rotator cuff repair rehabilitation," and articles that included rehabilitation protocols following superior capsular reconstruction surgery were reviewed. Two independent reviewers performed the search and quality assessment. Results: A total of 549 articles were yielded after our database search. Fourteen studies fulfilled our inclusion criteria and were included in the review. Study designs included 9 editorials, 3 case series, and 2 case reports. Each study included in this review used a unique rehabilitation algorithm that posed significant variability between the protocols. Four phases were identified to summarize each protocol and were used as a basis of discussiondsling versus brace time (3-6 weeks for comfort/removal vs complete immobilization), passive range of motion (immediately after surgery to initiation at 6 weeks), active range of motion (4-8 weeks), and strengthening/return to full activity (12-52 weeks). Initiation of rehabilitation, length of time spent in each phase, types of exercises, and overarching goals for return to function were significantly variable and were decided upon by the surgeon based on current massive rotator cuff repair protocols. Presently, there is no standard rehabilitation protocol for SCR. Conclusions: SCR is a relatively new procedure that is gaining rapid popularity with promising outcomes. Based on our review, there is no standard rehabilitation protocol in place; thus, it is not possible to recommend an evidence-based rehabilitation protocol following SCR at this time. Level of Evidence: Level V, systematic review of Level IV and V studies.
Introduction: Limited literature is available about the effects of extended (.24 hours) antibiotic use after primary and aseptic revision total joint arthroplasty (TJA) on rates of periprosthetic joint infection (PJI). The purpose of this study was to systematically review the outcomes of extended prophylactic antibiotic use. Methods: A systematic search on PubMed and EMBASE databases was done in August 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles that met inclusion criteria were screened by two separate authors. Basic patient demographics, route of delivery, type, dose, frequency of the antibiotic, rates of PJI, and length of stay were extracted. Results: A total of 11 articles published from 1979 to 2021 were included in the final analysis. Two studies evaluated aseptic revisions, seven evaluated primary TJA, and two studies evaluated both. Five studies were randomized controlled trials, one multicenter nonrandomized trial, and five retrospective cohort studies. All 11 studies used a cephalosporin or a penicillin antibiotic in both the control and cohort groups. Five studies used intravenous (IV) antibiotics, one study used oral (PO) antibiotics, and the other five studies used both IV and PO antibiotics. Length of stay was reported in three studies, all using IV antibiotics. All 11 studies evaluated rates of PJI, while four studies evaluated included rates of superficial surgical site infections. Four studies showed a statistically significant decrease in PJI when compared with a control group, while seven studies showed no statistically significant difference. Conclusion: There is conflicting evidence regarding the benefit of extended (.24 hours) antibiotics, IV or PO, after TJA. As of now, current guidelines do not support the use of extended antibiotics; future prospective clinical trials are needed to help support these claims.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.