The natural history of rotator cuff tears: a systematic review

Eljabu, W.; Klinger, Hans-Michael; Knoch, Marius von

doi:10.1007/s00402-015-2239-1

Cited by 37 publications

(25 citation statements)

References 18 publications

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“…Although this is an auto-controlled study, which is considered to be a weak design, there is evidence that the natural history of symptomatic rotator cuff injuries indicates that they mostly tend to progression and not to spontaneous resolution [222324]; hence, the outcome of implementation of the TR program is unlikely to be due to a placebo effect or the natural history of disease. It is noteworthy that the CM scale includes quantitative assessments of mobility and strength, and the study showed significant improvement in these areas.…”

Section: Discussionmentioning

confidence: 99%

Proposal and Evaluation of a Telerehabilitation Platform Designed for Patients With Partial Rotator Cuff Tears: A Preliminary Study

et al. 2016

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ObjectiveTo propose and evaluate the effectiveness of a telerehabilitation platform designed for patients with rotator cuff (RC) tears.MethodsDuring the first study phase, a virtual service platform that included information on RC tear pathology, joint care, and a series of instructions regarding therapeutic exercise was designed and created. Subsequently, in the clinical phase, a quasi-experimental study was performed. The platform was tested on patients and evaluated at baseline and at 1, 2, 3, and 6 months with respect to their pain levels and functionality on the Constant-Murley (CM) scale.ResultsEleven patients were included, 5 women and 6 men, with a median age of 55 years (range, 42–68 years). Pain diminished from a baseline value of 64 mm (range, 40–80 mm) to 16 mm (range, 0–30 mm) at 6 months (p<0.001). Points on the CM scale rose from a baseline value of 54 points (range, 51–66 points) to 85 points (range, 70–100 points) at 6 months (p=0.001). Functionality in daily living and work activities, movement, and strength exhibited significant changes at 6 months (p<0.05).ConclusionSignificant changes were observed in pain and functionality in this group of participants who used a telerehabilitation platform. To the best of our knowledge, this is the first study that included a specific program for RC tears.

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Section: Discussionmentioning

confidence: 99%

Proposal and Evaluation of a Telerehabilitation Platform Designed for Patients With Partial Rotator Cuff Tears: A Preliminary Study

et al. 2016

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“…10) On one hand, Mall et al 5) reported that across a 2-year or longer follow-up fullthickness rotator cuff tears increased by 5 mm in 18% of patients A B and partial tears progressed into full-thickness tears in 40% of patients (n=195). On the other hand, Fucentese et al 11) reported that the increase in tear size observed on magnetic resonance arthrograms after a 3.5-year follow-up was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that the accuracy of MRI in diagnosing full-thickness rotator cuff tears is greater than 95%. [9][10][11][12][13][14] In this study, we analyzed MRI findings of patients who were initially hospitalized for shoulder pain, which was diagnosed as a rotator cuff tear, were treated conservatively, but were later re-hospitalized for recalcitrant tears that were neglected without appropriate treatment. We investigated the natural history of the rotator cuff tears in terms of the change in cuff tear size, as measured on patients' MRI scans, and of clinical parameters.…”

Section: Introductionmentioning

confidence: 99%

Serial Magnetic Resonance Imaging to Determine the Progression of Neglected Recalcitrant Rotator Cuff Tears: A Retrospective Multicenter Study

Yoo

Park

Choi³

et al. 2017

Clinics in Shoulder and Elbow

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Background: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. Methods: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. Results: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. Conclusions: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery. (Clin Shoulder Elbow 2017;20(3):133-137)

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“…32 Other studies have found that it is unlikely that outcomes will worsen if a tear is left for 3 months post-trauma. [33][34][35] Most people who fail non-surgical treatment are likely to request surgery within the first 12 weeks. Beyond 12 weeks of non-surgical management there appears to be no further uptake in people requesting surgery.…”

Section: Non-surgical Management Of Rotator Cuff Tearsmentioning

confidence: 99%

Rotator cuff tears: is non-surgical management effective?

Sealey

Lewis

2016

Physical Therapy Reviews

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Background: Rotator cuff related shoulder pain is a common musculoskeletal complaint with an increasing number of people with shoulder pain undergoing surgical repair each year. The relationship between rotator cuff tendon tears and shoulder pain remains equivocal due to the high prevalence of tears in people without symptoms, which suggests that a proportion of people will undergo surgery on tissues not related to their symptoms. As a result there have been suggestions to initially manage atraumatic tears non-surgically. Objectives: The objective of this narrative review was to present current evidence regarding the assessment and management of full-thickness rotator cuff tears. Major Findings: To date three randomised controlled trials have compared surgical with non-surgical management of rotator cuff tears. Outcomes show a small but non-significant effect in favour of surgery. Only one study has looked at long term outcomes of greater than one year. Overall 129 subjects have completed a course of non-surgical management and therefore low participant numbers may not be sufficient to draw firm conclusions. Conclusions: Current evidence currently supports the consideration of a non-surgical approach in the management of people with shoulder symptoms and identified rotator cuff tears, for a 2 period of time.

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The natural history of rotator cuff tears: a systematic review

Cited by 37 publications

References 18 publications

Proposal and Evaluation of a Telerehabilitation Platform Designed for Patients With Partial Rotator Cuff Tears: A Preliminary Study

Proposal and Evaluation of a Telerehabilitation Platform Designed for Patients With Partial Rotator Cuff Tears: A Preliminary Study

Serial Magnetic Resonance Imaging to Determine the Progression of Neglected Recalcitrant Rotator Cuff Tears: A Retrospective Multicenter Study

Rotator cuff tears: is non-surgical management effective?

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