[RESEARCH] Rotator Cuff Tear - Surgery v. Conservative Rehab for 55+

Rotator Cuff Tear - Surgery v. Conservative Rehab for 55+

INTRO:
Non-traumatic rotator cuff tear is a common shoulder problem which can be treated either conservatively or operatively. Kukkonen et al. (2021) investigated the difference between clinical and radiological 5 year outcomes in patients aged over 55 years.


METHODS:
180 shoulders with symptomatic, non-traumatic supraspinatus tears were randomly assigned to:

1. Physiotherapy (Group 1)
2. Acromioplasty and physiotherapy (Group 2)
3. Rotator cuff repair, acromioplasty and physiotherapy (Group 3).

Primary Outcome:
Constant score.

Secondary Outcomes:
Visual analog scale for pain and patient satisfaction.
Radiological analysis included evaluation of glenohumeral osteoarthritis and rotator cuff tear arthropathy.

RESULTS:
The average tear size of the supraspinatus was 10 mm in all groups.

There were no significant differences in the average change of Constant score:

• 18.5 points in Group 1
• 17.9 points in Group 2
• 20.0 points in Group 3.

There were no statistically significant differences in the change of visual analog scale for pain and patient satisfaction. At follow-up there were no statistically significant differences in the mean progression of glenohumeral osteoarthritis or cuff tear arthropathy between the groups.

CONCLUSIONS:

• Operative treatment was no better than conservative treatment with regard to small non-traumatic single tendon supraspinatus tears in patients over 55 years of age.
• Operative treatment does not protect against degeneration of the glenohumeral joint or cuff tear arthropathy.
• Conservative treatment is a reasonable option for the primary initial treatment of this condition.

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SOURCE:
Kukkonen et al. 2021.
OPERATIVE VS. CONSERVATIVE TREATMENT OF SMALL NON-TRAUMATIC SUPRASPINATUS TEARS IN PATIENTS OVER 55 YEARS. Journal of Shoulder and Elbow Surgery

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 

Want to learn more or contact him?

Reach out online:

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@Grapplersperformance

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