Treatment of non-traumatic rotator cuff tears
This article was pointed out to us by one of our readers - thanks!
It is an extremely well done bit of clinical research.
The authors compared three different methods of treating symptomatic non-traumatic tears of the supraspinatus tendon in patients above 55 years of age.
The cost of each unit improvement in the Costant Score was 142 € in the PT group, 271 € in the acromioplasty and PT group and 288 € in the cuff repair and acromioplasty and PT group.
Patient satisfaction at one year of follow-up was 87% in the PT group, 96% in the acromioplasty and PT group, and 95% in the cuff repair and acromioplasty and PT group.
The authors compared three different methods of treating symptomatic non-traumatic tears of the supraspinatus tendon in patients above 55 years of age.
Inclusion criteria:
Age > 55 years
Atraumatic symptomatic supraspinatus tendon tear comprising < 75% of the tendon insertion and documented with MRI
Full range of motion of the shoulder
Written informed consent
Exclusion criteria
Atraumatic symptomatic supraspinatus tendon tear comprising < 75% of the tendon insertion and documented with MRI
Full range of motion of the shoulder
Written informed consent
Exclusion criteria
Age < 55 years
History of trauma relating to the onset of symptoms
A massive tendon tear involving the whole supraspinatus tendon and/or combined tear of two to three tendons
Stiffness of the glenohumeral joint (passive external rotation < 30° ± elevation < 120°)
Glenohumeral osteoarthritis with present osteophytes in radiographs
Systemic corticosteroid or antimetabolite medication
Significant malignant, hematological, endocrine, metabolic, rheumatoid or gastrointestinal disease
History of alcoholism, drug abuse, psychological or other emotional problems that are likely to invalidate informed consent
Previous surgery of same shoulder
Patient refusal
They randomized 180 shoulders with supraspinatus tendon tears into one of three equal sized groups: physical therapy, acromioplasty and physiotherapy, and rotator cuff repair, acromioplasty and physiotherapy. The outcomes were analyzed by intention to treat. There were no significant differences in the patient or cuff characteristics of those assigned to the three groups.
An independent observer found no between-group differences in the Constant score at final follow-up or in the mean change in the Constant score. They concluded that at one-year follow-up, operative treatment was no better than conservative treatment with regard to non-traumatic supraspinatus tears, and that conservative treatment should be considered as the primary method of treatment for this condition. It is of interest that at 3 months, the rotator cuff repair group had lower constant scores than the other two groups.
History of trauma relating to the onset of symptoms
A massive tendon tear involving the whole supraspinatus tendon and/or combined tear of two to three tendons
Stiffness of the glenohumeral joint (passive external rotation < 30° ± elevation < 120°)
Glenohumeral osteoarthritis with present osteophytes in radiographs
Systemic corticosteroid or antimetabolite medication
Significant malignant, hematological, endocrine, metabolic, rheumatoid or gastrointestinal disease
History of alcoholism, drug abuse, psychological or other emotional problems that are likely to invalidate informed consent
Previous surgery of same shoulder
Patient refusal
They randomized 180 shoulders with supraspinatus tendon tears into one of three equal sized groups: physical therapy, acromioplasty and physiotherapy, and rotator cuff repair, acromioplasty and physiotherapy. The outcomes were analyzed by intention to treat. There were no significant differences in the patient or cuff characteristics of those assigned to the three groups.
An independent observer found no between-group differences in the Constant score at final follow-up or in the mean change in the Constant score. They concluded that at one-year follow-up, operative treatment was no better than conservative treatment with regard to non-traumatic supraspinatus tears, and that conservative treatment should be considered as the primary method of treatment for this condition. It is of interest that at 3 months, the rotator cuff repair group had lower constant scores than the other two groups.
The cost of each unit improvement in the Costant Score was 142 € in the PT group, 271 € in the acromioplasty and PT group and 288 € in the cuff repair and acromioplasty and PT group.
Patient satisfaction at one year of follow-up was 87% in the PT group, 96% in the acromioplasty and PT group, and 95% in the cuff repair and acromioplasty and PT group.
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Consultation for those who live a distance away from Seattle.
**Check out the new Shoulder Arthritis Book - click here.**
Click here to see the new Rotator Cuff Book
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
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You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
