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
Little consensus has been achieved on conservative treatments in patients with Rotator Cuff Tears (RCTs).
To determine whether anatomical severities of RCTs were poor prognostic factors in conservative treatments.
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.
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).
Larger RCTs and concomitant SSC tear are poor prognostic factors for the conservative treatment of atraumatic RCTs.
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* 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;