Early mobilisation versus delayed protocols after reverse total shoulder arthroplasty for nonfracture indications: A systematic review and meta‐analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Purpose: This study aimed to compare clinical outcomes, range of motion, pain scores and complication rates between early and delayed mobilisation following reverse total shoulder arthroplasty (RTSA). Methods: A systematic review and meta-analysis were conducted according to 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Ovid Medline and Scopus databases were searched from inception through May 2025. Comparative studies evaluating early versus delayed mobilisation after RTSA were included. Methodological quality was assessed using the modified Coleman Methodology Score, while risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and the Risk of Bias 2 tool for randomised controlled trials. Pooled outcomes included patient-reported outcome scores, range of motion and postoperative complications. Results: Six studies with a total of 1763 patients were included. All included studies in this review investigated RTSA for nonfracture indications. Methodological quality ranged from fair to excellent across included studies. Meta-analysis showed that early mobilisation was associated with statistically significantly greater improvements in forward flexion (mean difference [MD] of 4.36°), abduction (MD of 4.95°) and pain visual analogue scale scores (MD of -0.40) compared to delayed mobilisation. No statistically significant differences were found between groups in Constant scores, American Shoulder and Elbow Surgeons scores, external rotation, dislocation rates, or revision surgery. Notably, early mobilisation was associated with a lower incidence of postoperative fractures. Conclusion: Early mobilisation after RTSA may yield modest improvements in pain and shoulder motion, though below established MCID thresholds. Importantly, it was associated with a lower risk of postoperative fractures and did not increase other complications. These findings support the safety of early rehabilitation, while highlighting the limited clinical magnitude of benefit. Level of Evidence: Level III.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it