Rotator cuff tears - surgery or non-operative treatment?
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Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis
These authors analyzed level I and II research comparing operative versus nonoperative management of full-thickness rotator cuff tears. The inclusion criteria were as follows: randomized controlled trial, full-thickness rotator cuff tear, and age 18 years or old. The exclusion criteria included any history of rotator cuff surgery and a follow-up period of less than 1 year.
These authors analyzed level I and II research comparing operative versus nonoperative management of full-thickness rotator cuff tears. The inclusion criteria were as follows: randomized controlled trial, full-thickness rotator cuff tear, and age 18 years or old. The exclusion criteria included any history of rotator cuff surgery and a follow-up period of less than 1 year.
After a review of 1013 articles only 3 qualified for inclusion representing 269 patients aged 59-65 years with 1-year follow-up.
While statistically significant differences favoring surgery were found in both Constant and VAS scores after 1 year, with mean differences of 5.64 (95% confidence interval, 2.06 to 9.21; P = .002) and −1.08 (95% confidence interval, −1.56 to −0.59; P < .0001), respectively, the differences were small and of questionable clinical significance.
The differences in both Constant and VAS scores were small and did not meet the minimal difference considered clinically significant.
While statistically significant differences favoring surgery were found in both Constant and VAS scores after 1 year, with mean differences of 5.64 (95% confidence interval, 2.06 to 9.21; P = .002) and −1.08 (95% confidence interval, −1.56 to −0.59; P < .0001), respectively, the differences were small and of questionable clinical significance.
The differences in both Constant and VAS scores were small and did not meet the minimal difference considered clinically significant.
Comment: Cuff repair is more costly than non-operative management and the recovery period (down time) can be protracted. Better evidence is necessary to determine which patients with rotator cuff tear will realize substantial benefit from this procedure.
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The reader may also be interested in these posts:
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
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