Nonoperative Treatment of Rotator Cuff Tears

Dickinson, Rebecca N.; Kuhn, John E.

doi:10.1016/j.pmr.2022.12.002

Cited by 7 publications

(3 citation statements)

References 59 publications

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“…Currently, treatment methods for tendon injuries mainly include conservative treatment and surgical repair [ 1 , 10 ]; however, these methods have limitations. Conservative treatment requires a long recovery period and often fails to fully restore tendon structure and function [ 11 ]. Although surgical repair can better address injured tendons, postoperative complications and tendon adhesion also occur [ 4 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Injectable self-assembled GDF5-containing dipeptide hydrogels for enhanced tendon repair

Zhang,

Wang,

Dai

et al. 2024

Materials Today Bio

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Section: Introductionmentioning

confidence: 99%

Injectable self-assembled GDF5-containing dipeptide hydrogels for enhanced tendon repair

Zhang,

Wang,

Dai

et al. 2024

Materials Today Bio

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“…Rotator cuff tears are prevalent in 8.2 to 23.0% of the population and are the most common cause of shoulder-related disability, with their etiology being multifactorial combinations of factors such as age-related degenerative changes, trauma, smoking, hypercholesterolemia, and family history [ 1 - 7 ]. Rehabilitation and physical therapy have been demonstrated to be an effective conservative treatment with the most favorable outcomes particularly observed in partial-thickness, degenerative nontraumatic full-thickness, and massive irreparable tears [ 8 ]. Surgical repair is often indicated for acute partial-thickness tears, full-thickness tears in younger patients, or full-thickness tears in older patients who have failed initial nonoperative treatment [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Preoperative Patient Resilience With Postoperative Patient-Reported Outcomes and Sleep Quality Following Arthroscopic Rotator Cuff Repair: A Systematic Review

Akhtar,

Aamer,

Alam

et al. 2024

Cureus

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Recent studies have shown that low preoperative resilience may lead to inferior outcomes following arthroscopic rotator cuff repair. Therefore, the purpose of this systematic review is to evaluate whether preoperative patient resilience is associated with outcome measures, including patient-reported outcome measurements (PROMs) and sleep quality, following arthroscopic rotator cuff repair. To perform the review, a literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the PubMed and Embase databases to gather studies related to the influence of preoperative resilience on postoperative outcomes of rotator cuff repair. Methodological quality and risk of bias were assessed using the Methodological Index for Non-randomized Studies (MINORS). Seven studies with 584 patients were included. Of 36 total reported postoperative outcomes, including PROMs and sleep quality, 14 had a significant positive correlation with higher preoperative resilience. One study reported that higher resilience was significantly correlated with worse sleep quality at a two-week follow-up but not at further follow-ups of up to 24 weeks. Significant differences in outcomes between patients with varying levels of resilience were assessed in five studies, all of which found that patients with higher resilience had significantly better outcomes or no significant differences in outcomes between patients with varying levels of preoperative resilience. In no study was it reported that patients with low resilience had better outcomes. Overall, approximately half of all reported postoperative outcome data was found to be significantly associated with preoperative resilience. Therefore, clinicians should preemptively identify those with low resilience and administer psychological interventions to limit inferior outcomes following arthroscopic rotator cuff repair.

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“…Treatment of rotator cuff tendon tears consists of conservative therapy and surgical management. Exercise therapy is generally an effective conservative treatment with favourable outcomes for partial‐thickness tears, degenerative nontraumatic full‐thickness tears and massive tears that cannot be repaired surgically [ 8 , 13 ]. However, given the risk of rotator cuff repair failure in large or massive tears, which has been noted to be as high as 94% in various case series [ 1 ], defining changes in tear size following exercise therapy as a treatment for degenerative rotator cuff tendon tears is especially important.…”

Section: Introductionmentioning

confidence: 99%

Scapular morphology does not predict supraspinatus tendon tear propagation following an individualised exercise therapy programme

Nazzal,

Mattar,

Winkler

et al. 2024

J. exp. orthop.

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PurposeTo determine whether scapular morphology could predict isolated supraspinatus tendon tear propagation after exercise therapy. We hypothesised that a larger critical shoulder angle (CSA) and type III acromial morphology predict a positive change in tear size.MethodsFifty‐nine individuals aged 40–70 years with isolated symptomatic high‐grade partial or full‐thickness supraspinatus tendon tears were included. Individuals participated in a structured, individualised 12‐week exercise therapy programme and underwent ultrasound to measure tear size at baseline and 12 months following therapy. Computed tomography images were segmented to create three‐dimensional subject‐specific bone models and reviewed by three trained clinicians to measure CSA and to determine acromion morphology based on the Bigliani classification. A binary logistic regression was performed to determine the predictive value of CSA and acromion morphology on tear propagation.ResultsThe CSA was 30.0 ± 5.4°. Thirty‐one individuals (52.5%) had type II acromial morphology, followed by type III and type I morphologies (25.4% and 22.0%, respectively); 81.4% experienced no change in tear size, four (6.8%) individuals experienced tear propagation and seven (11.9%) individuals had a negative change in tear size. No significant difference in tear propagation rates based on CSA or acromion morphology (not significant [NS]) was observed. The model predicted tear size status in 81.4% of cases but only predicted tear propagation 8.3% of the time. Overall, CSA and acromion morphology only predicted 24.3% (R2 = 0.243) of variance in tear propagation (NS).ConclusionsCSA and acromion morphology were NS predictors of tear propagation of the supraspinatus tendon 12 months following an individualised exercise therapy programme.Level of EvidenceII.

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Nonoperative Treatment of Rotator Cuff Tears

Cited by 7 publications

References 59 publications

Injectable self-assembled GDF5-containing dipeptide hydrogels for enhanced tendon repair

Injectable self-assembled GDF5-containing dipeptide hydrogels for enhanced tendon repair

Association of Preoperative Patient Resilience With Postoperative Patient-Reported Outcomes and Sleep Quality Following Arthroscopic Rotator Cuff Repair: A Systematic Review

Scapular morphology does not predict supraspinatus tendon tear propagation following an individualised exercise therapy programme

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