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KMID : 0361420160400020252
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Journal of Korean Academy of Rehabilitation Medicine
2016 Volume.40 No. 2 p.252 ~ p.262
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Clinical Outcomes of Conservative Treatment and Arthroscopic Repair of Rotator Cuff Tears: A Retrospective Observational Study
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Lee Woo-Hyung
Do Hyun-Kyung
Lee Joong-Hoon
Kim Bo-Ram
Noh Jee-Hyun
Choi Soo-Hyun
Chung Sun-Gun
Lee Shi-Uk
Choi Ji-Eun
Kim Sei-Hee
Kim Min-Jee
Lim Jae-Young
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Abstract
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Objective: To compare the clinical outcomes following conservative treatment and arthroscopic repair in patients with a rotator cuff tear.
Methods: In this retrospective study, patients aged >50 years with a symptomatic rotator cuff tear were reviewed. The rotator cuff tendons were evaluated using ultrasonography, shoulder magnetic resonance imaging or MR arthrography, and the patients with either a high-grade partial-thickness or small-to-medium-sized (≤3 cm) full-thickness tear were included in this study. The primary outcome measures were a pain assessment score and range of motion (ROM) at 1-year follow-up. The secondary outcomes were the rate of tear progression or retear along with the rate of symptom aggravation after the treatments.
Results: A total of 357 patients were enrolled, including 183 patients that received conservative treatment and 174 patients who received an arthroscopic repair. The pain assessment score (p<0.001) and the ROM in forward flexion (p<0.001) were significantly improved in both groups. The ROM in internal rotation did not significantly change after conservative treatment and arthroscopic repair. The pain assessment score and ROM were not significantly different between the two groups. Retear was observed in 9.6% of patients who had an arthroscopic repair and tear progression was found in 6.7% of those who underwent conservative treatment. The proportion of aggravation for pain and ROM did not significantly differ between the two groups.
Conclusion: The effectiveness of conservative treatment is not inferior to arthroscopic repair for patients >50 years old with a less than medium-sized rotator cuff tear in a 1-year follow-up period. Further study is warranted to find the optimal combination of conservative treatment for a symptomatic rotator cuff tear.
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KEYWORD
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Arthroscopy, Conservative treatment, Rotator cuff, Tendon injuries, Treatment outcome
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