Does Preoperative Conservative Management Affect the Success of Arthroscopic Repair of Partial Rotator Cuff Tear?

Autor: Ayanoglu T; Department of Orthopedics and Traumatology, Abant Izzet Baysal University, 14300 Bolu, Turkey., Ozer M; Department of Orthopaedics and Traumatology, Meram Medical Faculty of Necmettin, Erbakan University, Konya, Turkey., Cetinkaya M; Department of Orthopedics and Traumatology, Erzincan Mengucek Gazi Research Hospital, Erzincan, Turkey., Kaptan AY; Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey., Ulucakoy C; Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey., Ataoglu B; Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey., Kanatlı U; Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Indian journal of orthopaedics [Indian J Orthop] 2021 Aug 11; Vol. 56 (2), pp. 289-294. Date of Electronic Publication: 2021 Aug 11 (Print Publication: 2022).
DOI: 10.1007/s43465-021-00479-2
Abstrakt: Background: The aim of this study is to examine the effect of preoperative conservative treatment on the success of high-grade bursal/articular-sided partial rotator cuff repair.
Methods: Patients who had undergone shoulder arthroscopy in institution for Ellman Stage 3 bursal-side or articular-side partial tears between January 2008 and April 2018 were investigated retrospectively. This study assessed 201 patients diagnosed with isolated partial rotator cuff tears with a history of failed conservative management and persistent shoulder pain who underwent arthroscopic surgery. The demographic data of patients and pre- and postoperative The American Shoulder and Elbow Surgeons Shoulder Scores (ASES) that were recorded in the archive were evaluated.
Results: While 55 of the patients with Ellman grade 3 bursal-sided partial tears received preoperative conservative management for at least 6 months (Group 1), 62 of them could not tolerate conservative management and early arthroscopic repair was performed (Group 2). On the other hand, 42 of the patients with Ellman grade 3 articular-sided tears received preoperative conservative management (Group 3), 42 of them could not tolerate preoperative conservative management (Group 4). The mean ASES score improvement was 52.33 ± 8.55 for Group 1, 54.68 ± 11.29 for Group 2, 48.4 ± 7.77 for Group 3 and 49.33 ± 10.05 for Group 4. A statistically significant difference was found between the groups with one-way ANOVA test ( p  = 0.05). With the Tukey test, this difference was seen to be caused by Group 2.
Conclusion: Although there are many factors affecting its success, conservative management should be the first option in the treatment of partial rotator cuff tears. However, we think that it should not be insisted especially in patients with bursal-sided tears (> 50% of the tendon thickness) that cannot tolerate conservative management due to severe pain since the results of early arthroscopic repair of bursal-sided tears were found to be better.
Level of Evidence: Retrospective comparative study, Level III.
Competing Interests: Conflict of interestThe authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
(© Indian Orthopaedics Association 2021.)
Databáze: MEDLINE