Effectiveness of early versus delayed rehabilitation following total shoulder replacement: A systematic review.

To investigate the effectiveness of early versus delayed rehabilitation following total shoulder replacement. Intervention systematic review with narrative synthesis. MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Library were searched from inception to the 29 Randomised controlled trials comparing early versus delayed rehabilitation following primary anatomic, primary reverse, or revision total shoulder replacement. A revised Cochrane risk of bias assessment tool for randomised controlled trials was used, as well as the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence. A narrative synthesis was undertaken. Three eligible randomised controlled trials ( No differences were seen in patient-reported or clinician-reported outcomes at 12 months post-surgery between early and delayed rehabilitation following total shoulder replacement. There is very low-quality evidence that early rehabilitation may improve shoulder pain and function in the early post-operative phase following anatomic total shoulder replacement.