Background: The purpose of this study was to examine 5-year outcomes in a prospective cohort of patients previously enrolled in a nonoperative rotator cuff tear treatment program.
Methods: Patients with chronic (>3 months), full-thickness rotator cuff tears (demonstrated on imaging) who were referred to 1 of 2 senior shoulder surgeons were enrolled in the study between October 2008 and September 2010. They participated in a comprehensive, nonoperative, home-based treatment program. After 3 months, the outcome in these patients was defined as "successful" or "failed." Patients in the successful group were essentially asymptomatic and did not require surgery. Patients in the failed group were symptomatic and consented to undergo surgical repair. All patients were followed up at 1 year, 2 years, and 5 or more years.
Results: At 5 or more years, all patients were contacted for follow-up; the response rate was 84%. Approximately 75% of patients remained successfully treated with nonoperative treatment at 5 years and reported a mean rotator cuff quality-of-life index score of 83 of 100 (SD, 16). Furthermore, between 2 and 5 years, only 3 patients who had previously been defined as having a successful outcome became more symptomatic and underwent surgical rotator cuff repair. Those in whom nonoperative treatment had failed and who underwent surgical repair had a mean rotator cuff quality-of-life index score of 89 (SD, 11) at 5-year follow-up. The operative and nonoperative groups at 5-year follow-up were not significantly different (P = .11).
Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time.
Keywords: Shoulder; nonoperative treatment; outcome; quality of life; rotator cuff; surgery.
The Rotator Cuff Quality-Of-Life Index Predicts the Outcome of Nonoperative Treatment of Patients With a Chronic Rotator Cuff TearRS Boorman et al. J Bone Joint Surg Am 96 (22), 1883-8. PMID 25410506. - Clinical TrialThe RC-QOL was predictive of the outcome of nonoperative treatment of patients with a chronic full-thickness rotator cuff tear. Patients in whom the nonoperative treatmen …
A Randomized Clinical Trial Comparing Open to Arthroscopic Acromioplasty With Mini-Open Rotator Cuff Repair for Full-Thickness Rotator Cuff Tears: Disease-Specific Quality of Life Outcome at an Average 2-year Follow-UpNG Mohtadi et al. Am J Sports Med 36 (6), 1043-51. PMID 18354140. - Randomized Controlled TrialPatient outcomes improved from baseline to all postoperative measurement intervals. There was no difference in outcome at 1 and 2 years after surgery between the scope mi …
Functional Outcomes and Health-Related Quality of Life After Surgical Repair of Full-Thickness Rotator Cuff Tears Using a Mini-Open Technique: A Concise 10-Year Follow-up of a Previous ReportMK Saraswat et al. Am J Sports Med 43 (11), 2794-9. PMID 26394889.Postoperative improvements in function and HRQL after mini-open rotator cuff repair were retained at 10 years.
Rotator Cuff Tears in Overhead AthletesKJ Economopoulos et al. Clin Sports Med 31 (4), 675-92. PMID 23040553. - ReviewThe rotator cuff is under significant stress during overhead athletics, which can predictably lead to a certain spectrum of rotator cuff injuries in this population. Alth …
Epidemiology, Natural History, and Indications for Treatment of Rotator Cuff TearsRZ Tashjian. Clin Sports Med 31 (4), 589-604. PMID 23040548. - ReviewThe etiology of rotator cuff disease is likely multifactorial, including age-related degeneration and microtrauma and macrotrauma. The incidence of rotator cuff tears inc …
- Conservative Treatment / methods *
- Orthopedic Procedures / methods *
- Quality of Life *
- Rotator Cuff / surgery *
- Rotator Cuff Injuries / surgery *
- Aged, 80 and over
- Follow-Up Studies
- Magnetic Resonance Imaging
- Middle Aged
- Prospective Studies
- Rotator Cuff / diagnostic imaging
- Rotator Cuff Injuries / diagnosis
- Rotator Cuff Injuries / psychology
- Time Factors
- Trauma Severity Indices
- Treatment Outcome
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