Three-week immobilization vs. no immobilization in primary reverse total shoulder arthroplasty: a randomized controlled trial.

Abstract

There is no consensus about the length of the immobilization period after receiving a reverse shoulder arthroplasty (rTSA) for a cuff-deficient shoulder. The objective of this study was to determine whether patients receiving an rTSA for a cuff-deficient shoulder could be managed without any immobilization after surgery. Prospective randomized study that included a primary rTSA implanted for a cuff-deficient shoulder. Patients were randomized into group 1 (3-week immobilization) or group 2 (without immobilization). Pain was assessed with the visual analog scale (VAS) the day before surgery, at 24 and 48 hours after surgery, at 7 days, at 3 weeks, and at 3, 6, 12, and 24 months. The functional outcome was evaluated before surgery and at 12- and 24-month follow-up using the Constant score. Complications were also recorded at all the points throughout. A total of 64 patients were included. The mean age was 73.5 years (range, 68.5-79.5 years). There were 50 women and 14 men. Group 1 consisted of 32 patients and 32 were allocated to group 2. There were no significant differences between the 2 groups in terms of age, gender, and the preoperative VAS and Constant scores. No statistically significant differences were noted between the 2 groups relative to the postoperative VAS at 24 hours (P = .576), 48 hours (P = .296), 7 days (P = .512), 3 weeks (P = .114), 3 months (P = .823), 6 months (P = .623), 12 months (P = .388), and 24 months (P = .515). Neither were there any differences in the Constant score at 12 months (P = .501) or at 24 months (P = .566). Furthermore, no complications were reported during the follow-up period in any group. Based on the results of this study, there is no need to immobilize the arm after receiving an rTSA for a cuff-deficient shoulder. The pain and functional outcomes are comparable to those obtained with a 3-week immobilization period.