Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis

  • Karasuyama, Masaki (Department of Physical Therapy, Kyushu Nutrition Welfare University) ;
  • Gotoh, Masafumi (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Tahara, Keiji (Department of Orthopedic Surgery, Tahara Orthopedic Clinic) ;
  • Kawakami, Junichi (Department of Physical Therapy, Kyushu Nutrition Welfare University) ;
  • Madokoro, Kazuya (Department of Physical Therapy, Technical School of Medical and Welfare Ryokuseikan) ;
  • Nagamatsu, Takashi (Kurume University School of Medicine Graduate School) ;
  • Imai, Takaki (Department of Rehabilitation, Keishinkai Hospital) ;
  • Harada, Nobuya (Kurume University School of Medicine Graduate School) ;
  • Kudo, Yu (Kurume University School of Medicine Graduate School) ;
  • Shiba, Naoto (Department of Orthopedic Surgery, Kurume University)
  • Received : 2020.01.25
  • Accepted : 2020.03.24
  • Published : 2020.06.01
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Abstract

Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2° (2 months), 159.0° (6 months), 168.1° (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires "vitality" section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05). Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.

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References

  1. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19:116-20. https://doi.org/10.1016/j.jse.2009.04.006
  2. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006;88:1699-704. https://doi.org/10.2106/00004623-200608000-00002
  3. Gialanella B, Prometti P. Effects of corticosteroids injection in rotator cuff tears. Pain Med 2011;12:1559-65. https://doi.org/10.1111/j.1526-4637.2011.01238.x
  4. Downie BK, Miller BS. Treatment of rotator cuff tears in older individuals: a systematic review. J Shoulder Elbow Surg 2012;21:1255-61. https://doi.org/10.1016/j.jse.2011.11.019
  5. Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F. Methods for meta-analysis in medical research. Chichester: John Wiley and Sons; 2000.
  6. Mischke JJ, Emerson Kavchak AJ, Courtney CA. Effect of sternoclavicular joint mobilization on pain and function in a patient with massive supraspinatus tear. Physiother Theory Pract 2016;32:153-8. https://doi.org/10.3109/09593985.2015.1114691
  7. Miller RM, Popchak A, Vyas D, et al. Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg 2016;25:641-9. https://doi.org/10.1016/j.jse.2015.08.048
  8. Baumer TG, Chan D, Mende V, et al. Effects of rotator cuff pathology and physical therapy on in vivo shoulder motion and clinical outcomes in patients with a symptomatic full-thickness rotator cuff tear. Orthop J Sports Med 2016;4:2325967116666506.
  9. Lambers Heerspink FO, van Raay JJ, Koorevaar RC, et al. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg 2015;24:1274-81. https://doi.org/10.1016/j.jse.2015.05.040
  10. Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of nontraumatic rotator cuff tears: a randomized controlled trial with two years of clinical and imaging follow-up. J Bone Joint Surg Am 2015;97:1729-37. https://doi.org/10.2106/JBJS.N.01051
  11. Collin PG, Gain S, Nguyen Huu F, Ladermann A. Is rehabilitation effective in massive rotator cuff tears. Orthop Traumatol Surg Res 2015;101(4 Suppl):S203-5. https://doi.org/10.1016/j.otsr.2015.03.001
  12. Nejati P, Akbari F. Exercise therapy for total tear of rotator cuff: a case report. Asian J Sports Med 2014;5:67-70.
  13. Boorman RS, More KD, Hollinshead RM, et al. The rotator cuff quality-of-life index predicts the outcome of nonoperative treatment of patients with a chronic rotator cuff tear. J Bone Joint Surg Am 2014;96:1883-8. https://doi.org/10.2106/JBJS.M.01457
  14. Benazzo F, Marullo M, Pietrobono L. Supraspinatus rupture at the musculotendinous junction in a young woman: version 2. J Orthop Traumatol 2014;15:231-4. https://doi.org/10.1007/s10195-013-0271-x
  15. Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg 2013;22:1371-9. https://doi.org/10.1016/j.jse.2013.01.026
  16. Krischak G, Gebhard F, Reichel H, et al. A prospective randomized controlled trial comparing occupational therapy with home-based exercises in conservative treatment of rotator cuff tears. J Shoulder Elbow Surg 2013;22:1173-9. https://doi.org/10.1016/j.jse.2013.01.008
  17. Kijima H, Minagawa H, Nishi T, Kikuchi K, Shimada Y. Long-term follow-up of cases of rotator cuff tear treated conservatively. J Shoulder Elbow Surg 2012;21:491-4. https://doi.org/10.1016/j.jse.2011.10.012
  18. Tanaka M, Itoi E, Sato K, et al. Factors related to successful outcome of conservative treatment for rotator cuff tears. Ups J Med Sci 2010;115:193-200. https://doi.org/10.3109/03009734.2010.493246
  19. Moosmayer S, Lund G, Seljom U, et al. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: a randomised controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br 2010;92:83-91. https://doi.org/10.1302/0301-620X.92B1.22609
  20. Baydar M, Akalin E, El O, et al. The efficacy of conservative treatment in patients with full-thickness rotator cuff tears. Rheumatol Int 2009;29:623-8. https://doi.org/10.1007/s00296-008-0733-2
  21. Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. J Shoulder Elbow Surg 2008;17:863-70. https://doi.org/10.1016/j.jse.2008.04.005
  22. Koubaa S, Ben Salah FZ, Lebib S, Miri I, Ghorbel S, Dziri C. Conservative management of full-thickness rotator cuff tears: a prospective study of 24 patients. Ann Readapt Med Phys 2006;49:62-7. https://doi.org/10.1016/j.annrmp.2005.08.008
  23. Ainsworth R. Physiotherapy rehabilitation in patients with massive, irreparable rotator cuff tears. Musculoskeletal Care 2006;4:140-51. https://doi.org/10.1002/msc.85
  24. Heers G, Anders S, Werther M, Lerch K, Hedtmann A, Grifka J. Efficacy of home exercises for symptomatic rotator cuff tears in correlation to the size of the defect. Sportverletz Sportschaden 2005;19:22-7. https://doi.org/10.1055/s-2004-813883
  25. Vad VB, Warren RF, Altchek DW, O'Brien SJ, Rose HA, Wickiewicz TL. Negative prognostic factors in managing massive rotator cuff tears. Clin J Sport Med 2002;12:151-7. https://doi.org/10.1097/00042752-200205000-00002
  26. Shibata Y, Midorikawa K, Emoto G, Naito M. Clinical evaluation of sodium hyaluronate for the treatment of patients with rotator cuff tear. J Shoulder Elbow Surg 2001;10:209-16. https://doi.org/10.1067/mse.2001.113501
  27. Goldberg BA, Nowinski RJ, Matsen FA 3rd. Outcome of nonoperative management of full-thickness rotator cuff tears. Clin Orthop Relat Res 2001;(382):99-107.
  28. Yamada N, Hamada K, Nakajima T, Kobayashi K, Fukuda H. Comparison of conservative and operative treatments of massive rotator cuff tears. Tokai J Exp Clin Med 2000;25:151-63.
  29. Wirth MA, Basamania C, Rockwood CA Jr. Nonoperative management of full-thickness tears of the rotator cuff. Orthop Clin North Am 1997;28:59-67. https://doi.org/10.1016/s0030-5898(05)70264-9
  30. Hawkins RH, Dunlop R. Nonoperative treatment of rotator cuff tears. Clin Orthop Relat Res 1995;(321):178-88.
  31. Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS. Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop Relat Res 1993;(294):103-10.
  32. Itoi E, Tabata S. Conservative treatment of rotator cuff tears. Clin Orthop Relat Res 1992;(275):165-73.
  33. Seida JC, LeBlanc C, Schouten JR, et al. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med 2010;153:246-55. https://doi.org/10.7326/0003-4819-153-4-201008170-00263
  34. Piper CC, Hughes AJ, Ma Y, Wang H, Neviaser AS. Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg 2018;27:572-6. https://doi.org/10.1016/j.jse.2017.09.032

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