Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial

Ranebo, Mats C.; Hallgren, Hanna C. Björnsson; Holmgren, Theresa; Adolfsson, Lars

doi:10.1016/j.jse.2019.10.013

Cited by 47 publications

(57 citation statements)

References 47 publications

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“…However, of the 252 patients included in the SR, only 40 (16%) were diagnosed with traumatic tears of the rotator cuff (24 randomised to surgery; 16 to physiotherapist-led exercise). Since the publication of this SR, one further RCT ( n = 58) focusing specifically on traumatic rotator cuff tears has been published [ 10 ]. This RCT compared surgical repair with a programme of physiotherapist-led exercise for acute traumatic rotator cuff tears located mainly within supraspinatus [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Since the publication of this SR, one further RCT ( n = 58) focusing specifically on traumatic rotator cuff tears has been published [ 10 ]. This RCT compared surgical repair with a programme of physiotherapist-led exercise for acute traumatic rotator cuff tears located mainly within supraspinatus [ 10 ]. At 12 months, there was no significant between-group difference in terms of shoulder pain and function.…”

Section: Introductionmentioning

confidence: 99%

“…At 12 months, there was no significant between-group difference in terms of shoulder pain and function. Re-tear was reported in 6.5% of participants undergoing repair and tear size progression greater than 5 mm in 29.2% of participants undergoing the programme of physiotherapist-led exercise [ 10 ]. Hence, there is uncertainty about optimal interventions for traumatic rotator cuff tears based on evidence from a limited number of patients and from RCTs with relatively short-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study)

Littlewood

Wade

Butler-Walley

et al. 2021

Pilot Feasibility Stud

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Background Clinically, a distinction is made between types of rotator cuff tear, traumatic and non-traumatic, and this sub-classification currently informs the treatment pathway. It is currently recommended that patients with traumatic rotator cuff tears are fast tracked for surgical opinion. However, there is uncertainty about the most clinically and cost-effective intervention for patients with traumatic rotator cuff tears and further research is required. SPeEDy will assess the feasibility of a fully powered, multi-centre randomised controlled trial (RCT) to test the hypothesis that, compared to surgical repair (and usual post-operative rehabilitation), a programme of physiotherapist-led exercise is not clinically inferior, but is more cost-effective for patients with traumatic rotator cuff tears. Methods SPeEDy is a two-arm, multi-centre pilot and feasibility RCT with integrated Quintet Recruitment Intervention (QRI) and further qualitative investigation of patient experience. A total of 76 patients with traumatic rotator cuff tears will be recruited from approximately eight UK NHS hospitals and randomly allocated to either surgical repair and usual post-operative rehabilitation or a programme of physiotherapist-led exercise. The QRI is a mixed-methods approach that includes data collection and analysis of screening logs, audio recordings of recruitment consultations, interviews with patients and clinicians involved in recruitment, and review of study documentation as a basis for developing action plans to address identified difficulties whilst recruitment to the RCT is underway. A further sample of patient participants will be purposively sampled from both intervention groups and interviewed to explore reasons for initial participation, treatment acceptability, reasons for non-completion of treatment, where relevant, and any reasons for treatment crossover. Discussion Research to date suggests that there is uncertainty regarding the most clinically and cost-effective interventions for patients with traumatic rotator cuff tears. There is a clear need for a high-quality, fully powered, RCT to better inform clinical practice. Prior to this, we first need to undertake a pilot and feasibility RCT to address current uncertainties about recruitment, retention and number of and reasons for treatment crossover. Trial registration ClinicalTrials.gov (NCT04027205) – Registered on 19 July 2019. Available via

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study)

Littlewood

Wade

Butler-Walley

et al. 2021

Pilot Feasibility Stud

View full text Add to dashboard Cite

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“…2,3 Rotator cuff tears can be classified according to the location size and extent of the tears. 4,5 Small tears can be treated nonsurgically 6,7 or surgically. 8,9 Most of the literature suggests similar outcomes between nonsurgical and surgical treatment in the short to medium term.…”

mentioning

confidence: 99%

“…8,9 Most of the literature suggests similar outcomes between nonsurgical and surgical treatment in the short to medium term. 7,9,10 Moosmayer et al 8 found in a randomized controlled trial that surgical repair of small and medium-sized rotator cuff tears had better outcomes at 10 years than treatment with physiotherapy. 8 However, tear enlargement may be a concern for patients who do not undergo surgical repair.…”

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confidence: 99%

Arthroscopic Single Lateral Row Repair Technique for Small Rotator Cuff Tears

Cheow

Lie

2021

Arthroscopy Techniques

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Small symptomatic rotator cuff tears are a common problem seen by orthopaedic surgeons. Arthroscopic repair has been shown to have favorable outcomes for these lesions. There is as yet no consensus on the ideal technique for the arthroscopic repair of small rotator cuff tears. We present a single lateral row technique for the repair of such lesions, which we believe to be reproducible and effective, that achieves good approximation of the tear while reducing the chance of suture cutouts.

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Subscapularis Tendon Tears

Yoo

Kim

2023

Shoulder Arthroscopy

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Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial

Cited by 47 publications

References 47 publications

Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study)

Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study)

Arthroscopic Single Lateral Row Repair Technique for Small Rotator Cuff Tears

Subscapularis Tendon Tears

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