Surgery or conservative treatment for rotator cuff tear: a meta-analysis

Ryösä, Anssi; Laimi, Katri; Äärimaa, Ville; Lehtimäki, Kaisa; Kukkonen, Juha; Saltychev, Mikhail

doi:10.1080/09638288.2016.1198431

Cited by 104 publications

(81 citation statements)

References 43 publications

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“…In another Finnish study, Kukkonen et al stated that there was no significantly or clinically important difference in outcome between three interventions (physiotherapy, acromioplasty and physiotherapy, and rotator cuff repair and physiotherapy) in the treatment of symptomatic, non-traumatic rotator cuff tears. 32 8 12 Underlining these findings, systematic reviews and meta-analyses have provided high-quality evidence that shows the lack of efficacy in the repair of atraumatic, degenerative rotator cuff tears [33][34][35] and acromioplasty. 27 35-37 secular trends in ankle, wrist, elbow and hip arthroscopic surgery…”

Section: Why Are There Secular Trends In Shoulder Arthroscopy?mentioning

confidence: 99%

Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?

et al. 2020

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ObjectivesTo assess the rates and secular trends of different joint arthroscopies—shoulder, elbow, wrist, hip, knee and ankle—in Finland between 1997 and 2016.DesignRetrospective nationwide registry study.ParticipantsAll adults in Finland with any arthroscopic intervention procedure code for knee, shoulder, ankle, wrist, elbow or hip arthroscopy between 1 January 1997 and 31 December 2016 were included.Main outcome measuresIncidence rate of arthroscopic surgery per 100 000 person-years.ResultsThe rate of knee and shoulder arthroscopies declined after reaching a peak in 2006 and 2007, respectively. The rates of wrist, elbow and hip joint arthroscopies declined after their 2014 peak. At the same time, the median age of patients who had knee, ankle and hip arthroscopy decreased, whereas the age of patients who had shoulder arthroscopy increased.ConclusionsNumerous randomised controlled trials point to lack of efficacy of the most common knee and shoulder arthroscopic procedures. It should not be assumed that this has contributed to decreased rates of arthroscopic surgery. The concurrent decrease in most of the other joint arthroscopic procedures was unexpected.

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Section: Why Are There Secular Trends In Shoulder Arthroscopy?mentioning

confidence: 99%

Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?

et al. 2020

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“…Current literature supports the use of non-surgical intervention for rotator cuff tears. 19 To date only three RCTs have directly compared non-surgical with surgical management, with a total of 129 non-surgically managed participants. 6,17,18 Current literature has yet to address long term outcomes of non-surgical intervention with further longitudinal studies necessary.…”

Section: Discussionmentioning

confidence: 99%

Rotator cuff tears: is non-surgical management effective?

Sealey

Lewis

2016

Physical Therapy Reviews

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Background: Rotator cuff related shoulder pain is a common musculoskeletal complaint with an increasing number of people with shoulder pain undergoing surgical repair each year. The relationship between rotator cuff tendon tears and shoulder pain remains equivocal due to the high prevalence of tears in people without symptoms, which suggests that a proportion of people will undergo surgery on tissues not related to their symptoms. As a result there have been suggestions to initially manage atraumatic tears non-surgically. Objectives: The objective of this narrative review was to present current evidence regarding the assessment and management of full-thickness rotator cuff tears. Major Findings: To date three randomised controlled trials have compared surgical with non-surgical management of rotator cuff tears. Outcomes show a small but non-significant effect in favour of surgery. Only one study has looked at long term outcomes of greater than one year. Overall 129 subjects have completed a course of non-surgical management and therefore low participant numbers may not be sufficient to draw firm conclusions. Conclusions: Current evidence currently supports the consideration of a non-surgical approach in the management of people with shoulder symptoms and identified rotator cuff tears, for a 2 period of time.

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“…Attempts to summarize results of existing RCTs with 12-month results have been made in 2 recent systematic reviews and meta-analyses 227,240 . Both studies have included results from the same 3 studies (Moosmayer, Kukkonen and Lambers-Heerspink).…”

Section: Acromioplasty Without Cuff Repairmentioning

confidence: 99%

Rotator Cuff Tears : Short- and long-term aspects on treatment outcome

Ranebo

2020

Linköping University Medical Dissertations

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Surgery or conservative treatment for rotator cuff tear: a meta-analysis

Cited by 104 publications

References 43 publications

Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?

Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?

Rotator cuff tears: is non-surgical management effective?

Rotator Cuff Tears : Short- and long-term aspects on treatment outcome

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