What happens to patients when we do not repair their cuff tears? Five-year rotator cuff quality-of-life index outcomes following nonoperative treatment of patients with full-thickness rotator cuff tears
| Autor: | James P. Wiley, Richard S. Boorman, Nicholas G. H. Mohtadi, Kristie D More, Ian K.Y. Lo, Kelly Brett, Robert M. Hollinshead |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Conservative Treatment Asymptomatic Rotator Cuff Injuries Rotator Cuff 03 medical and health sciences 0302 clinical medicine Quality of life medicine Humans Orthopedic Procedures Orthopedics and Sports Medicine Rotator cuff Prospective Studies Prospective cohort study Aged Ultrasonography Aged 80 and over Surgical repair 030222 orthopedics Trauma Severity Indices business.industry Rotator cuff injury 030229 sport sciences General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome medicine.anatomical_structure Cuff Quality of Life Tears Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 27:444-448 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2017.10.009 |
| Popis: | Background The purpose of this study was to examine 5-year outcomes in a prospective cohort of patients previously enrolled in a nonoperative rotator cuff tear treatment program. Methods Patients with chronic (>3 months), full-thickness rotator cuff tears (demonstrated on imaging) who were referred to 1 of 2 senior shoulder surgeons were enrolled in the study between October 2008 and September 2010. They participated in a comprehensive, nonoperative, home-based treatment program. After 3 months, the outcome in these patients was defined as “successful” or “failed.” Patients in the successful group were essentially asymptomatic and did not require surgery. Patients in the failed group were symptomatic and consented to undergo surgical repair. All patients were followed up at 1 year, 2 years, and 5 or more years. Results At 5 or more years, all patients were contacted for follow-up; the response rate was 84%. Approximately 75% of patients remained successfully treated with nonoperative treatment at 5 years and reported a mean rotator cuff quality-of-life index score of 83 of 100 (SD, 16). Furthermore, between 2 and 5 years, only 3 patients who had previously been defined as having a successful outcome became more symptomatic and underwent surgical rotator cuff repair. Those in whom nonoperative treatment had failed and who underwent surgical repair had a mean rotator cuff quality-of-life index score of 89 (SD, 11) at 5-year follow-up. The operative and nonoperative groups at 5-year follow-up were not significantly different (P = .11). Conclusion Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. |
| Databáze: | OpenAIRE |
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