A scoping review of tendon transfer surgeries and postsurgical physical therapy interventions in individuals with massive rotator cuff tears

Abstract

ObjectiveTo identify tendon transfer surgeries and post‐surgical physical therapy interventions in people with massive rotator cuff (RC) tears.MethodsThe literature search was conducted in the MEDLINE, Science Direct, Scopus, Web of Science, and PEDro databases from inception to September 2022. Studies with patients diagnosed with massive RC tears undergoing tendon transfers that reported physical therapy interventions after surgery were included. Two reviewers pooled the data into ad hoc summary tables with the following information: authors, year, study characteristics (sample size, tendon transfer surgical used, approach type, preoperative risk, deficit addressed, additional surgical interventions), and physical therapy interventions (early stage, intermediate stage, and advanced stage).ResultsForty‐four articles (59.0% case series) were included, with a total sample of 1213 participants. The most frequently used surgery was the isolated tendon transfer of the latissimus dorsi (49.1%). Most of the studies reported three main stages of physical therapy interventions after tendon transfer surgery: early stage (lasting 5–6 weeks), intermediate stage (started at 7–12 weeks), and advanced stage (started at 12 weeks). Physical therapy interventions included passive, active‐assisted, resisted therapeutic exercise, and hydrotherapy.ConclusionsThe evidence regarding physical therapy interventions after RC tendon transfer surgery is limited to the number and duration of the stages and general characteristics without specifying the type and dose of the interventions. Future research with high methodological quality should integrate more detailed rehabilitation protocols to better guide therapeutic decisions after RC transfer surgery.This article is protected by copyright. All rights reserved.

The effect of rehabilitation time on functional recovery after arthroscopic rotator cuff repair: a systematic review and meta-analysis

“…( Galatz et al, 2005 ; Killian et al, 2012 ; Thomopoulos, Williams & Soslowsky, 2003 ). The tendon transfer procedure and subsequent physical therapy strategies used to identify individuals with large rotator cuff (RC) injuries were reported in a scoping review ( Salazar-Méndez et al, 2023 ). The study discovered that evidence from existing databases on physical therapy interventions after RC tendon transfer surgery was limited to the number and duration of phases and general characteristics without specifying the type and dose of intervention.…”

“…When properly planned, passive range of motion exercises can minimize postoperative loss of motion and protect the repaired rotator cuff. Salazar-Méndez et al (2023) described three phases of physical therapy intervention (early, intermediate, and late) based on the time it took for the tendon to heal. The bleeding phase, for example, required higher care.…”