Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial

Heerspink, Frederik O. Lambers; Raay, Jos J. A. M. van; Koorevaar, Rinco C.T.; Eerden, Pepijn J. M. van der; Westerbeek, Robin E.; Riet, Esther van ’t; Akker‐Scheek, Inge van den; Diercks, Ron L.

doi:10.1016/j.jse.2015.05.040

Cited by 124 publications

(60 citation statements)

References 33 publications

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“…The difference is small at 5 years however and may not be clinically significant [ 21 ]. Other studies have shown one year outcome scores to be similar comparing operative and non operative treatment in randomised control trials [ 22 , 23 ]. However, at 3 years pain and activities of daily living scores were better in the operative group compared to conservative treatment [ 9 ].…”

Section: Discussionmentioning

confidence: 95%

The Effect of Hand Dominance on Functional Outcome Following Single Row Rotator Cuff Repair

Kelly¹,

Donald²,

Boland³

et al. 2017

TOORTHJ

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Introduction:Rotator cuff tears are a common cause of shoulder disability and pain. Excellent outcomes can be obtained with surgical treatment although this outcome is affected by several factors. We sought to investigate the effect of hand dominance on subjective functional outcome post rotator cuff repair. Methods:All patients who had rotator cuff repair over a calendar year were identified and followed up at 3 years post operatively. Patients were consented for inclusion in the study and demographic data, hand dominance and functional outcome data was collected. L'insalata shoulder questionnaire was used for outcome data collection. SPSS version 22 was used for statistical analysis where appropriate. Results:144 patients were included in this study. Mean age was 63 +/-10.1 years in the dominant side group and 62 +/-8.6 years in the nondominant group. 92 patients had dominant side surgery and 52 had non-dominant side surgery. There was a statistically significant correlation between dominant hand and operated side (P=0.005). The mean overall outcome score was marginally higher in the dominant surgery group with a mean of 89.8 +/-14.2 compared with a mean of 87.4 +/-17.5 in the non-dominant group. Multivariate linear regression analysis revealed this difference to be non-significant (p = 0.4). Conclusion:No difference was found in the functional outcome of rotator cuff repair between dominant and non-dominant side surgery. This information will help in counselling patients who are concerned about the potential impact of rotator cuff repair on the function of their dominant hand.

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Section: Discussionmentioning

confidence: 95%

The Effect of Hand Dominance on Functional Outcome Following Single Row Rotator Cuff Repair

Kelly¹,

Donald²,

Boland³

et al. 2017

TOORTHJ

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“…Visual analog pain scales and patient satisfaction were not significantly different among the treatment groups. In another randomized controlled trial in patients with degenerative full-thickness cuff tears, 31 patients were treated nonoperatively, and 25 underwent surgical repair [30]. Differences in functional outcomes measured by the Constant score were not observed at 1 year of follow-up.…”

Section: Nonoperative Managementmentioning

confidence: 99%

Natural History of Degenerative Rotator Cuff Tears

Codding

Keener

2018

Curr Rev Musculoskelet Med

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Purpose of Review In the past several years, there have been significant advances in our understanding of the natural history of rotator cuff disease. Studies have continued to provide valuable insight into the clinical, radiographic, and anatomic features of these atraumatic tears. Our purpose is to summarize the findings and contributions from these recent high-quality studies. Recent Findings Current research has continued to describe and provide understanding into the natural history of atraumatic rotator cuff disease, including symptom progression, tear enlargement, and the development of arthritis. This knowledge has allowed identification of tears with higher risk of disease progression. Additionally, studies have investigated, with long-term healing data, whether the natural history of degenerative rotator cuff tears can be altered with surgical intervention. Summary Recent studies have shown encouraging mid to long-term healing data and clinical outcome scores for smaller tears in younger patients with minimal fatty infiltration. Future research should focus on obtaining long-term healing data, functional outcome data, and refining surgical indications for rotator cuff repair. Identifying patients with specific tear characteristics amendable to healing will allow us to provide a long-term, durable repair, thus interrupting the natural history of degenerative rotator cuff disease.

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“…This condition with increasing incidence in the active population explain the critical socioeconomic burden that should be considered [3,4]. Several studies are currently ongoing to evaluate the potential superiority of conservative treatment over a surgical approach [7][8][9][10][11][12]. Although much of the healthcare expenditure is due to intervention and hospitalization, the economic burden of the rehabilitation period may be underestimated [1].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Supervised versus Unsupervised Rehabilitation for Rotator-Cuff Repair: Systematic Review and Meta-Analysis

Longo

Berton

Ambrogioni

et al. 2020

IJERPH

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Background: The objective of the present study was to compare the efficacy between supervised and unsupervised rehabilitation after rotator-cuff (RC) repair in terms of clinical outcomes, visual-analog-scale (VAS) score, range of motion (ROM), and risk of retear. Material: a comprehensive search of Pubmed, CINAHL, Cochrane, EMBASE, Ovid, and Google Scholar databases through a combination of the following keywords with logical Boolean operators: “informed”, “uninformed”, “unsupervised”, “supervised”, “rehabilitation”, “physical therapy”, “physical therapies”, “postoperative period”, “physical-therapy techniques”, “physical-therapy technique”, “exercise”, “exercise therapy”, “rotator cuff”, “rotator-cuff tear”, and “rotator-cuff repair”. For each article included in the study, the following data were extracted: authors, year, study design, sample size and demographic features, RC tear characteristics, clinical outcomes, ROM, VAS score, retear rate, and time of follow-up. Meta-analysis was performed in terms of VAS score. Results: Four randomized control trials with 132 patients were included. One study demonstrated significant improvement in VAS, active ROM, and the activity of the muscle’s motor units at stop and during maximal effort in supervised patients. Another one showed lower retear rates in the supervised group. The remaining two randomized controlled trials did not reveal any significant differences between supervised and unsupervised rehabilitation in terms of clinical outcomes. Moreover, higher costs were described for supervised rehabilitation. The VAS was not significantly different in the two groups (9.9 compared with 8.25, p = 0.23). Conclusions: although several publications address the problem of RC lacerations, there is a paucity of evidence in the literature regarding the effectiveness of supervised and unsupervised rehabilitation protocols. This systematic review and meta-analysis showed no significant differences between the two types of rehabilitation in terms of VAS scores, while outlining the pros and cons of each protocol.

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Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial

Cited by 124 publications

References 33 publications

The Effect of Hand Dominance on Functional Outcome Following Single Row Rotator Cuff Repair

The Effect of Hand Dominance on Functional Outcome Following Single Row Rotator Cuff Repair

Natural History of Degenerative Rotator Cuff Tears

Cost-Effectiveness of Supervised versus Unsupervised Rehabilitation for Rotator-Cuff Repair: Systematic Review and Meta-Analysis

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