OTSR - 2026-07-11 - Journal Article
Kinetics of recovery after arthroscopic rotator cuff repair: early motion, delayed strength, and age-related differences.
Antoni M, Moisa O, Bagga H, Nourissat G
Topics
Key Takeaway
Strength recovery after arthroscopic rotator cuff repair reaches only 49.2% of its 12-month value at 3 months, significantly lagging behind ROM recovery (69.5–79.2%) at the same timepoint.
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Summary
This retrospective single-center study characterized the temporal sequence of functional recovery in 167 patients after primary arthroscopic full-thickness rotator cuff repair, evaluating ROM, strength, and PROMs at 1, 3, 6, and 12 months. ROM approached near-complete recovery (≥90% of 12-month value) by 6 months for forward flexion and internal rotation, while strength reached only 75.8% at 6 months. Only 57.5–62.9% of patients achieved near-complete PROM recovery by 6 months, and older age was independently associated with achieving near-complete Constant score recovery at 6 months on multivariate analysis.
Key Limitation
Absence of tear size, tissue quality, and repair configuration data precludes determining whether the observed recovery kinetics differ across the spectrum of rotator cuff pathology that most influences retear risk and functional outcome.
Original Abstract
BACKGROUND
Arthroscopic rotator cuff repair (RCR) provides reliable improvements in pain and function, yet the temporal pattern of postoperative recovery remains poorly characterized. In particular, the kinetics of recovery across functional domains and the determinants of early recovery are not well established.
PURPOSE
The primary objective of this study was to assess the kinetics of functional recovery following arthroscopic rotator cuff repair. The secondary objectives were (1) to identify factors associated with the speed of recovery and (2) to determine whether a temporal sequence exists between recovery of range of motion and muscle strength.
METHODS
A retrospective single-center study included 167 consecutive patients who underwent primary arthroscopic repair of full-thickness rotator cuff tears between 2022 and 2023, with a minimum follow-up of 12 months. Clinical evaluation was performed preoperatively and at 1, 3, 6, and 12 months postoperatively, including patient-reported outcome measures (Constant score, ASES, SSV), range of motion (ROM), and muscle strength. Functional recovery was expressed as a percentage of the 12-month value. Near-complete recovery was defined as ≥90% of the final outcome. Univariate and multivariate analyses were performed to identify factors associated with early recovery.
RESULTS
At 3 months, forward flexion, abduction, external rotation, and internal rotation reached 79.2%, 73.9%, 69.5%, and 74.9% of their 12-month values, respectively. At 6 months, these values were 91.0%, 88.2%, 82.5%, and 90.4%. Strength reached 49.2% and 75.8% of its 12-month value at 3 and 6 months, respectively. External rotation recovery was lower than that of forward flexion, abduction, and internal rotation at 3 months (p = 0.018, 0.027, and 0.041), with no differences at 6 months (p = 0.42, 0.37, and 0.48). Strength recovery was lower than that of forward flexion, abduction, and internal rotation at 3 months (p = 0.004, 0.009, and 0.012), but comparable to external rotation (p = 0.18), and to all ROM parameters at 6 months. PROMs reached 74.6% (Constant), 79.5% (ASES), and 77.1% (SSV) at 3 months, and 88.2%, 89.6%, and 88.4% at 6 months, respectively. At 6 months, 59.9%, 62.9%, and 57.5% of patients achieved near-complete recovery for the Constant score, ASES, and SSV, respectively. In multivariate analysis, older age was independently associated with achieving near-complete recovery of the Constant score at 6 months (p = 0.048).
CONCLUSION
Functional recovery after arthroscopic RCR follows a predictable but non-uniform sequence, characterized by early improvements in ROM and patient-reported outcomes, followed by delayed strength restoration. At 6 months, 59.9% to 62.9% of patients achieve near-complete recovery depending on the outcome measure. These findings provide clinically relevant benchmarks for patient counseling and support the need for prolonged rehabilitation strategies focused on strength recovery.
LEVEL OF EVIDENCE
III; retrospective cohort study.