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KMID : 0948920150140010011
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Clinical Pain
2015 Volume.14 No. 1 p.11 ~ p.15
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Rotator Cuff Tears: When, Why Do We Consider Repair?
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Kim Chul-Hong
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Abstract
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Rotator cuff tears are among common conditions affecting the shoulder and are often asymptomatic. However, there is substantial debate concerning their management. Nono-perative treatment is successful in a large number of pa-tients especially in older, sedentary patients. Nevertheless, we consider repair the rotator cuff tears. Because, not all patients respond to a nonoperative program, especially if they are young and active, and tear size, retraction, and the extent of atrophy and fatty degeneration which are im-portant factors in reparability will progress. According to a literature review, in the patients younger than 65 years old with chronic full thickness tears and acute tears in any age group excluding patients with small (＜1∼1.5 cm) full thick-ness tears, early surgical intervention is warranted due to significant risks of irreversible changes with nonoperative treatment and a high likelihood of healing if repair is per-formed. On the other hand, initial nonoperative treatment should be considered in patients with partial-thickness tears (except maybe larger bursal-sided tears), potentially small full-thickness tears, and older patients over age 65 or 70 with chronic full-thickness rotator cuff tears or individuals of any age with large or massive rotator cuff tears with chronic, irreversible rotator cuff changes already present.
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KEYWORD
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Rotator cuff, Non-operative treatment, Repair
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