Results of early operative treatment of rotator cuff tears with acute symptoms

Lähteenmäki, Hannu E.; Virolainen, Petri; Hiltunen, Arto; Heikkilä, Jari; Nelimarkka, Olavi

doi:10.1016/j.jse.2005.07.006

Cited by 78 publications

(74 citation statements)

References 30 publications

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“…For patients that had sudden onset of symptoms and significant impairment of function due to a full RC tear, the results of early operative treatment were better than conservative treatment or late surgery. A similar result was obtained for a group of patients operated on within 3 weeks of the beginning of their symptoms [54]. In fact, early operative treatment was beneficial regardless of tear type if the onset of symptoms was acute.…”

Section: Asymptomatic Ftrcts Increase With Agesupporting

confidence: 77%

“…Successful RC repair returned 95% of the patients to preinjury level of function. It was concluded that the results support early arthroscopic rotator cuff repair in young, active patients [54]. While age is considered a major factor in determining traumatic vs overuse, after review of 12 nonprospective case series, Lazarides concluded that RCTs in young patients is a different disease than found in the elderly [59].…”

Section: Asymptomatic Ftrcts Increase With Agementioning

confidence: 98%

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Determining Work-Relatedness of Acute Shoulder Trauma. Review 2017

Rhode¹,

Rhode²

2017

MOJOR

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The chronicity of rotator cuff tears and their cause with increasing age has been extensively studied resulting in widely varying prevalence estimates. Focusing on a reported prevalence rate that increases with age to as high as 80% for 70 year olds can result in denial of reimbursement for work-related rotator cuff tears based on the presumed existence of underlying tendon pathology. The age at which inherent degeneration of the rotator cuff becomes a consideration in worker's comp judgments is vague at best. There are instances of acute shoulder trauma that occur in individuals as young as 20 years and even younger in athletes before significant tendon degeneration occurs. Multiple studies report low prevalence rates of asymptomatic rotator cuff tears in individuals less than 50 years. Acute shoulder trauma occurring at work in young workers provides strong evidence that the exposure event underlies any resulting shoulder disorder rather than tendon degeneration and as such is compensable. It can be questioned whether work-related acute shoulder trauma occurring at any age should be attributed to inherent tendon degeneration. IntroductionRotator cuff disease is the most common upper extremity disability [1]. Tendons are connective tissues primarily made up of aligned type I collagen fibrils. The primary cells in tendons are fibroblasts which produce the extra cellular matrix components. As a tendon ages, there is a drop in both cell numbers and cell synthetic activity which could affect mechanical function as tendon structure and composition are altered. These changes likely underlie the increase in tendon injuries with aging [2]. The principal focus of this review is the determination between acute traumatic and chronic degenerative rotator cuff tears (RCTs) which has huge implications for compensation of workrelated injuries. Determining the underlying cause of an RCT is complicated by an increasing incidence of asymptomatic rotator cuff disease with increasing age due to ongoing degeneration of the shoulder tendons. As the age of patient's increases and along with possible RC degeneration, it becomes increasingly difficult to exclusively attribute shoulder injuries to work-related trauma. However, ethically and given the original intent of worker compensation legislation, work-related trauma to the shoulder should be compensable [3].Determining the chronicity of tendon tears remains an issue that is still being pursued. Codman in 1931 stated four prescient hypotheses for RC supraspinatus tendon lesions: (1) trauma, (2) calcification, (3) necrosis or osteoarthritis, or (4) direct result of attrition [4]. Extrinsic and intrinsic factors are recognized to affect rotator cuff tears. Neer identified extrinsic factors based on impingement of the cuff against the coracoacromial arch when the arm is elevated in a forward direction leading to tendonitis and tears [5]. Variable morphology of the acromion includes spurs [6][7][8] and a hook-shaped acromion [9,10] that influence the degree of impingement and li...

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Section: Asymptomatic Ftrcts Increase With Agesupporting

confidence: 77%

Section: Asymptomatic Ftrcts Increase With Agementioning

confidence: 98%

Determining Work-Relatedness of Acute Shoulder Trauma. Review 2017

Rhode¹,

Rhode²

2017

MOJOR

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“…Bassett and Cofield (1983) reported that the postoperative pain relief was acceptable when the surgery was performed within 3-months from the injury. More recently, Lähteenmäki, et al (2006) also reported that acute rotator cuff tears could always be successfully repaired to its original insertion within 3weeks from the injury (Lähteenmäki et al 2006). The results of the present study indicated that there were no significant changes in the tissue sound speed after the detachment of the supraspinatus tendon.…”

Section: F = Ea ∆L Equation 2 Lsupporting

confidence: 59%

Elasticity of the Supraspinatus Tendon-muscle Unit is Preserved after Acute Tendon Tearing in the Rabbit

Mineta

Sano

Ichinose

et al. 2008

Tohoku J. Exp. Med.

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“…Similarly, Bassett and Cofield [4] reported improved results with surgical repair after acute dislocations. In acute rotator cuff tears, Lahteenmaki et al [19] reported better outcomes after early surgery compared to nonoperative management or delayed repair. Loew et al [24] highlighted the importance of addressing rotator cuff tears after dislocations in older patients to prevent the development of persistent symptoms and secondary degenerative changes.…”

Section: Discussionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

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Background The rotator cuff plays a significant role in the static and dynamic stability of the glenohumeral joint. Rotator cuff tears may occur after shoulder dislocations, whether in younger athletes or older patients with agerelated tendon degeneration. Untreated tears may cause persistent pain, dysfunction, instability, and degenerative changes. A thorough understanding of when to look for rotator cuff tears after shoulder dislocations and how best to manage them may decrease patients' pain and improve function. Questions/purposes We systematically reviewed the available literature to better understand (1) when a rotator cuff tear should be suspected after a dislocation, (2) whether surgical or nonsurgical approaches result in better scores for pain and satisfaction in patients with rotator cuff tears resulting from shoulder dislocations, and (3) whether intraarticular lesions, rotator cuff tears, or both should be addressed when surgery is performed. Methods We systematically searched MEDLINE 1 , CI-NAHL, and EMBASE for studies published from 1950 to 2012. We included studies reporting outcomes after treatment in patients with rotator cuff tears and shoulder dislocations. We excluded case reports, studies without any treatment, and studies about patients treated with arthroplasty. Five Level III and six Level IV studies were ultimately selected for review. Results Patients with persistent pain or dysfunction after a shoulder dislocation often had a concomitant rotator cuff tear. Surgical repair resulted in improved pain relief and patient satisfaction compared to nonoperative management. Repair of the rotator cuff, along with concomitant capsulolabral lesions, helped restore shoulder stability. While these findings are based on Level III and IV evidence, better long-term studies with larger cohorts are needed to strengthen evidence-based recommendations. Conclusions Persistent pain and dysfunction after a shoulder dislocation should prompt evaluation of the rotator cuff, especially in contact or overhead athletes, patients older than 40 years, or those with nerve injury. Surgery should be considered in the appropriately active patient with a rotator cuff tear after dislocation. While the current literature suggests improved stability and function after surgical repair of the rotator cuff, higher-quality prospective studies are necessary to make definitive conclusions.

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Results of early operative treatment of rotator cuff tears with acute symptoms

Cited by 78 publications

References 30 publications

Determining Work-Relatedness of Acute Shoulder Trauma. Review 2017

Determining Work-Relatedness of Acute Shoulder Trauma. Review 2017

Elasticity of the Supraspinatus Tendon-muscle Unit is Preserved after Acute Tendon Tearing in the Rabbit

Rotator Cuff Tear and Glenohumeral Instability

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