Impact of early versus delayed mobilization after arthroscopic rotator cuff repair in small and medium-sized tears: a prospective randomized study

Abstract Purpose To compare early versus delayed mobilization following arthroscopic single-row knotless rotator cuff repair for small and medium-sized tears, performed in the beach-chair position without the use of an abduction sling. Methods A prospective randomized study was conducted on 70 patients aged 20–70 years with small and medium-sized full-thickness supraspinatus tears repaired using single-row knotless suture anchors (one or two depending on tear size). Patients were assigned to early mobilization (EPM, n = 35) or delayed mobilization (DPM, n = 35). Outcomes were assessed using range of motion (ROM), pain (VAS), Constant–Murley and UCLA scores, and MRI tendon integrity at 12 months. Results EPM patients showed faster ROM recovery at 3 months (mean 130° vs. 115°; p = 0.02), but one re-tear (2.8%) occurred in this group compared to DPM, where no re-tears occurred. At 12 months, both groups achieved comparable functional and pain outcomes. Conclusion Early mobilization accelerates short-term ROM recovery, whereas both early and delayed protocols result in comparable functional and pain outcomes by 12 months. Given the limited number of retear events and the absence of a prespecified tear size subgroup analysis, no definitive recommendation can be made regarding a differential mobilization strategy according to tear size.