Editorial Commentary: Shoulder Abduction Braces Are Unnecessary After Rotator Cuff Repair: A Simple Sling Confers No Clinically Important Disadvantages.

Abstract

Evaluations of practice patterns after rotator cuff repair reveal that both simple slings and abduction braces are commonly used, with the latter most frequently preferred in the United States. A preference for a shoulder abduction brace may be formed on the basis of the widespread belief that they confer potential advantages of a biomechanical protective effect through reducing load at the repair site and/or by improving local blood flow and healing. However, these theoretical benefits have not been substantiated across several randomized controlled trials, which have failed to show any advantage of an abduction brace with respect to key outcome measures, including postoperative pain severity, retear rates, and patient-reported outcome measures, when compared with using a simple sling. This may in part be attributable to limited additional efficacy of abduction braces and poor compliance. Regardless, abduction braces are more expensive; more difficult for the patient to manage; negatively impact activities of daily living, sleep, and satisfaction; and may increase the risk of falls. In the absence of any proven significant benefit across several randomized controlled trials and meta-analyses, and concerns regarding potential adverse effects, it is my recommendation that clinicians routinely using abduction braces reconsider the simple sling.