Anelise Silveira

My research has contributed to changing how upper extremity injuries are managed in both surgical and non-surgical patients. Through three randomized controlled trials—one recognized as a “Game Changer” at the 2015 AAOS Meeting and another published in The Journal of Bone and Joint Surgery —we showed that early mobilization after rotator cuff and distal biceps tendon repairs is safe and does not compromise tendon repair, challenging long-standing beliefs about postoperative immobilization. A network meta-analysis I led, including of 756 patients, confirmed these findings, supporting more flexible, patient-centered rehabilitation. The distal biceps trial was selected by OrthoEvidence—a global platform curating high-quality orthopaedic research—for its ‘research summaries,’ a distinction granted to only 5% of published studies. This recognition increased visibility of the findings among key decision-makers who can use the evidence to inform policy, improve care, and potentially reduce system costs. These works also reflect the interdisciplinary collaborative approach of my research where researchers, physiotherapists, orthopaedic surgeons, and more recently patients with lived experiences work together to develop best care models for patients.

As many patients are managed non-operatively, I co-led a cohort study of 143 patients that showed that many with rotator cuff–related shoulder pain improve with exercise-based physiotherapy. We demonstrated that a criteria-based progressive exercise-based physiotherapy program can allow individualized patient-centered care within a standardized rehabilitation program. A referral algorithm also developed through this work helped guide timely surgical consultation when needed, avoiding unnecessary delays for those that needed surgery and is being widely used in Edmonton, Canada.

I also co-led the development of an online rehabilitation guideline resource that supported this work, now accessed by over 5,400 clinicians globally. Physical therapists reported high satisfaction, using it to support individualized, evidence-based care of shoulder pain patients.

My doctoral research in the workers’ compensation setting showed that a structured care pathway—compared to usual care—enabled earlier treatment, faster access to modified duties, and more efficient return to work. It also showed that older workers experienced significant delays in care, despite similar clinical presentations, leading to longer claim durations. These findings highlight the need for more equitable access and timely care delivery to improve outcomes for both patients and healthcare systems, and we are in the process of knowledge translation for key stakeholders.