Sling vs. Abduction Brace After Rotator Cuff Repair: The Impact on Sleep and Recovery

Sling vs. Abduction Brace After Rotator Cuff Repair: The Impact on Sleep and Recovery

Introduction

Recovering from arthroscopic rotator cuff repair (ARCR) comes with several challenges, including pain, anxiety, and disrupted sleep. Traditionally, patients have been immobilized with an abduction brace, believed to aid healing by placing the shoulder in an abducted position. However, recent research suggests that a sling may provide similar healing benefits while significantly improving sleep quality, reducing anxiety, and increasing patient satisfaction.

A 2024 study published in The American Journal of Sports Medicine explored this comparison, and the findings offer valuable insights for orthopedic surgeons, physical therapists, and patients undergoing rotator cuff repair oai_citation:0‡li-et-al-2024-sling-results-in-better-sleep-quality-and-less-anxiety-early-after-arthroscopic-rotator-cuff-repair-a.pdf.

Key Findings: Sling vs. Abduction Brace

1. Improved Sleep Quality with a Sling

Sleep disturbance is a common issue for patients recovering from ARCR, often due to discomfort caused by an abduction brace. In this study, patients using a sling reported significantly better sleep quality compared to those in a brace:

-Pittsburgh Sleep Quality Index (PSQI) at 6 weeks

-Brace Group: 11.1 ± 2.7

-Sling Group: 9.2 ± 2.3 (p < 0.001)

By three months post-op, both groups showed improved sleep, but early recovery was easier for sling users oai_citation:1‡li-et-al-2024-sling-results-in-better-sleep-quality-and-less-anxiety-early-after-arthroscopic-rotator-cuff-repair-a.pdf.

2. Less Anxiety and Higher Patient Satisfaction

Recovery is not just physical-mental well-being plays a critical role. The Self-rating Anxiety Scale (SAS) revealed significantly lower anxiety levels at six weeks for patients in the sling group:

- SAS Scores at 6 Weeks:

- Brace Group: 53.1 ± 14.5

- Sling Group: 47.1 ± 14.1 (p = 0.01)

Additionally, sling users reported higher satisfaction scores with their recovery experience (p < 0.001) oai_citation:2‡li-et-al-2024-sling-results-in-better-sleep-quality-and-less-anxiety-early-after-arthroscopic-rotator-cuff-repair-a.pdf.

3. Comparable Pain Levels and Tendon Healing

One of the main concerns about using a sling instead of an abduction brace is whether it affects pain levels or tendon healing. This study found no significant difference between the two groups:

- Pain at 6 Weeks:

- Brace Group: 5.6 ± 1.5

- Sling Group: 5.0 ± 1.5 (p = 0.02)

- Tendon Healing at 1 Year:

- Brace Group: 91% healed

- Sling Group: 88% healed (p = 0.59)

This suggests that sling immobilization does not compromise the healing process while offering superior comfort during the early weeks of recovery oai_citation:3‡li-et-al-2024-sling-results-in-better-sleep-quality-and-less-anxiety-early-after-arthroscopic-rotator-cuff-repair-a.pdf.

Why This Matters for Patients and Clinicians

For Patients:

Expect better sleep and less anxiety in the early recovery phase.

A sling is easier to use, allowing more freedom for basic tasks.

Pain and healing are not negatively affected by using a sling.

For Surgeons and Physical Therapists:

The early benefits of a sling make it a strong option for post-op recovery.

 Recommending a sling may improve patient compliance and satisfaction.

No significant downside in terms of long-term healing and functional outcomes.

Conclusion: Should We Move Away from the Abduction Brace?

This study suggests that a sling is a viable and possibly superior alternative to an abduction brace for post-ARCR immobilization. With better sleep, lower anxiety, and comparable healing, clinicians should strongly consider recommending slings as part of their standard post-op protocol.

For more expert orthopedic insights and rehabilitation tips, stay connected with SportsSmithMD.

References & Further Reading

> Original Study: Li et al., The American Journal of Sports Medicine, 2024 oai_citation:4‡li-et-al-2024-sling-results-in-better-sleep-quality-and-less-anxiety-early-after-arthroscopic-rotator-cuff-repair-a.pdf.

> More on Shoulder Surgery & Rehab: Visit SportsSmithMD.