Importance There are many different published rehabilitation protocols with various guidelines for type and duration of immobilisation, exercises and return to preoperative activities.
Objective The aim of this study is to evaluate the evidence regarding rehabilitation following anteroinferior capsulolabral repair in patients with anterior shoulder instability.
Evidence review The American Society of Shoulder and Elbow Therapists' (ASSET) consensus guideline was assessed with the Appraisal of Guidelines and Research & Evaluation (AGREE) II tool. A literature search was then conducted including Medline (Pubmed), Embase, PEDro and the Cochrane Database for related randomised controlled trials (RCTs) that compared different rehabilitation protocols. Duplications were removed. Studies were first excluded based on title and abstract and then based on full text. Included articles were assessed for methodological quality with the National Institute for Health and Clinical Excellence (NICE) guidelines manual appendix C and for level of evidence with the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. A qualitative synthesis of data from included studies was performed.
Findings Our average score of the ASSET guideline was 49%. The initial search resulted in 902 articles. After screening the title and abstract, only 2 studies met the inclusion criteria. A background search in the 4 orthopaedic journals with the highest impact factor (IF) resulted in 6 background articles, which emphasise the differences between current rehabilitation protocols.
Conclusions Although based on limited evidence, the ASSET guideline (2010) is applicable at this time. Based on controlled studies, there is insufficient evidence to suggest 1 rehabilitation protocol over another to treat patients after an arthroscopic Bankart procedure for shoulder instability. Further research is required.
Level of evidence Level IV.
- Treatment / Technique
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Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.
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