Article

[Conservative management of full-thickness rotator cuff tears. A prospective study of 24 patients].

Service de Rééducation et de Réadaptation Fonctionnelle, Institut National d'Orthopédie M.-Kassab, 2010 La-Manouba Tunisie.
Annales de Réadaptation et de Médecine Physique 03/2006; 49(2):62-7. DOI:10.1016/j.annrmp.2005.08.008 pp.62-7
Source: PubMed

ABSTRACT To evaluate the efficacy of conservative treatment of full-thickness rotator cuff tears.
A prospective open study of patients with full-thickness rotator cuff tears. The diagnosis was confirmed by ultrasonography examination. Therapeutic efficacy was evaluated before treatment, at the end of the treatment, and at 1, 3 and 6 months. Pain and handicap intensity were measured by a visual analogue scale, by the algo-functional Constant score, by articular mobility and, finally, by the resumption of daily and/or professional activities. Successful treatment was considered with a VAS pain score<or=20, a VAS handicap score<or=20, and a Constant score>or=80.
Twenty-four patients, mean age 59 years, with full-thickness rotator cuff tears for 9 months, on average, were included in the study. The parameters of pain function and handicap improved significantly since the end of treatment. The Constant score improved greatly, from 44.8 before treatment to 71.8 at the end of treatment and 74.2 at 6 months. This improvement continued until 3 months after treatment. The rate of success was 75% at 6 months.
Despite the small sample size, our study confirm that rehabilitation should always be performed before a decision of surgical repair.

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    Article: Factors related to successful outcome of conservative treatment for rotator cuff tears.
    Minoru Tanaka, Eiji Itoi, Katsumi Sato, Junichiro Hamada, Shin Hitachi, Yuichi Tojo, Masahito Honda, Shiro Tabata
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    ABSTRACT: Much controversy exists as to the management of full-thickness tears of the rotator cuff. Not all patients with rotator cuff tears require surgical treatment. We have little information whether there are factors that are related to successful outcome of conservative treatment. AIM. The purpose of this study was to determine the factors related to the successful outcome following conservative treatment. This study included 123 shoulders in 118 patients with full-thickness tears of the rotator cuff diagnosed by high-resolution magnetic resonance imaging with a microscopy coil. All patients were treated conservatively for at least 3 months. Clinical symptoms improved in 65 shoulders in 62 patients by conservative treatment (conservative group), but remained unchanged or aggravated in 58 shoulders in 56 patients, who eventually underwent surgical repair (surgical group). The following parameters showed significant differences: 1) integrity of the intramuscular tendon of the supraspinatus (24.1% in the surgical group and 58.4% in the conservative group showed an intact intramuscular tendon); 2) supraspinatus muscle atrophy (occupancy ratio was 69.8% in the surgical group and 78.0% in the conservative group); 3) impingement sign (positive in 79.3% in the surgical group and 30.7% in the conservative group); and 4) external rotation angle (35.0 degrees in the surgical group and 52.2 degrees in the conservative group). The success rate of conservative treatment was 87% in the cases with at least three of these four factors. These four factors are useful in selecting patients who will respond well to conservative treatment before initiating the treatment.
    Upsala journal of medical sciences 08/2010; 115(3):193-200. · 0.73 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

6 months
 
age 59 years
 
articular mobility
 
conservative treatment
 
efficacy
 
full-thickness rotator cuff tears
 
handicap intensity
 
pain function
 
patients
 
professional activities
 
prospective open study
 
rehabilitation
 
small sample size
 
Successful treatment
 
surgical
 
Therapeutic efficacy
 
ultrasonography examination
 
visual analogue scale