WHAT HAPPENS TO PATIENTS WHEN WE DO NOT REPAIR THEIR CUFF TEARS? FIVE-YEAR ROTATOR CUFF QUALITY-OF-LIFE INDEX OUTCOMES FOLLOWING NON-OPERATIVE TREATMENT OF PATIENTS WITH FULL-THICKNESS ROTATOR CUFF TEARS.

Review written by Dr Teddy Willsey info

BACKGROUND & OBJECTIVE

The variability in rotator cuff tear symptoms and treatment is extensive and thus poses a conundrum for clinicians, surgeons and researchers. There is favorable research supporting both surgical and non-operative approaches to long-term management. Previous models have looked at 2-year follow ups, but not 5 years. The aim of this study was to answer the question of whether non-operative management of chronic full-thickness rotator cuff tears is a lasting solution, by examining 5-year outcomes in patients enrolled in a non-operative rotator cuff tear treatment program.

METHODS

Patients voluntarily enrolled in this prospective study. Inclusion criteria included chronic symptoms (>3 months), full thickness supraspinatus or infraspinatus tears (confirmed by ultrasound or MRI), age 40-85 years. Patients qualified for the study following a successful 3-month rehabilitation, defined by both the patient and surgeon mutually agreeing continuation of non-operative treatment was the best course of treatment.

A few points of consideration regarding patient demographic and epidemiology:

  • 72% of patients had the full thickness RC tear on their dominant arm
  • 63% had significantly decreased external rotation strength at the onset of their rehabilitation
  • Average patient age at onset was 60 y/o
  • Ratio of traumatic to insidious onset was nearly 50/50

RESULTS

The study started with 104 patients whom met the inclusion criteria. Attrition rates were normal for a 5-year longitudinal study, with 9 lost due to non-follow-up at 2 years and 14 more lost at 5 years. Of the remaining 79

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