The Open Orthopaedics Journal




ISSN: 1874-3250 ― Volume 13, 2019
RESEARCH ARTICLE

Prognostic Factors for Conservative Treatments of Atraumatic Rotator Cuff Tears



Takuya Sekiguchi1, Junichiro Hamada2, *, Yoshihiro Hagiwara3, Akira Ando4, Takashi Watanabe5, Mitsukuni Yamaguchi6, Kiyohisa Ogawa7
1 Department of Orthopaedic Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate 020-0066, Japan
2 Department of Orthopaedic Surgery, Kuwano Kyoritsu Hospital, 2-9-18, Shima, Koriyama, Fukushima 963-8034, Japan
3 Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
4 Department of Orthopaedic Surgery, Matsuda Hospital, 17-1, Tatsutayashiki, Sanezawa, Izumi-ku, Sendai, Miyagi 981-3217, Japan
5 Department of General Health, Japan Community Health Care Organization Sendai Hospital, 3-16-1, Tsutsumi-machi, Aoba-ku, Sendai, Miyagi 981-8501, Japan
6 Therapy Laboratory, 1-1-5 Dobashi, Miyamae-ku, Kawasaki, Kanagawa 216-0005, Japan
7 Department of Orthopaedic Surgery, Eijyu General Hospital, 2-23-16, Higashiueno, Taito-ku, Tokyo 110-8645, Japan

Abstract

Background:

Little consensus has been achieved on conservative treatments in patients with Rotator Cuff Tears (RCTs).

Objective:

To determine whether anatomical severities of RCTs were poor prognostic factors in conservative treatments.

Method:

This study included 102 shoulders with atraumatic RCTs diagnosed by magnetic resonance imaging. Partial-thickness tears were identified in 15 shoulders and full-thickness tears in 87 shoulders. Three patients had a concomitant subscapularis (SSC) tendon tear. All patients were treated conservatively with the administration of non-steroidal anti-inflammatory drugs and physical therapy. The visual analog scale (VAS), Constant scores, and active range of motion were evaluated as clinical outcomes. Pearson’s chi-square test and Student’s t test, Mann-Whitney U test, one-way analysis of variance (ANOVA), or Kruskal-Wallis test was performed to compare the participant’s characteristics and clinical data. Treatment effectiveness among the tear size groups and with/without SSC tear groups was assessed using a two-factor repeated measures ANOVA.

Results:

Larger tears were associated with less improvement in VAS (p = 0.032). At the initial and final visits, larger tears showed lower constant scores (p = 0.014 and p < 0.001, respectively) and restricted forward elevation (FE) (p = 0.042 and p = 0.013, respectively). Shoulders with SSC tear showed higher VAS, lower constant scores, and lower FE at the final visit (p = 0.002, p = 0.001, and p=0.019, respectively). Patients with SSC tear underwent surgery more frequently than those without tear (p < 0.001).

Conclusion:

Larger RCTs and concomitant SSC tear are poor prognostic factors for the conservative treatment of atraumatic RCTs.

Keywords: Rotator cuff tears, Conservative treatment, Tear size, Tear pattern, Shoulder disorder, Anatomical severities.


Article Information


Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 26
Last Page: 31
Publisher Id: TOORTHJ-13-26
DOI: 10.2174/1874325001913010026

Article History:

Received Date: 05/09/2018
Revision Received Date: 18/12/2018
Acceptance Date: 11/01/2019
Electronic publication date: 31/1/2019
Collection year: 2019

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© 2019 Sekiguchi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this Department of Orthopaedic Surgery, Kuwano Kyoritsu Hospital, 2-9-18, Shima, Koriyama, Fukushima 963-8034, Japan; Tel: +81-24-933-5422; Fax: +81-24-923-6169;
E-mail: i-hamada@koriyama-h-coop.or.jp




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