Most patients who underwent nonoperative treatment for rotator cuff tears had anatomic tear deterioration, with poorer functional outcomes found in large tear size increases and progression of muscle atrophy, according to results.
Of 89 patients with small- to medium-sized full-thickness rotator cuff tears primarily treated by physiotherapy, researchers performed a re-examination with sonography on 49 patients who still had unrepaired tears at 8.8-year follow-up. Researchers used shoulder scores to assess shoulder function. Primary outcome measures included progression of tear size, muscle atrophy and fatty degeneration, and the Constant score.
Results showed an increase in mean tear size by 8.3 mm and 4.5 mm in the anterior-posterior plane and in the medial-lateral plane, respectively. Researchers noted a change in tear size from –5 mm to +9.9 mm in 68% of patients, from 10 mm to 19.9 mm in 16% of patients and from 20 mm or greater in 16% of patients. Patients with tear increases of less than 20 mm had a Constant score of 81 points, while those with tear increases of 20 mm or greater had a Constant score of 58.5 points.
Of 37 patients who underwent re-examination by MRI, results showed progression of muscle atrophy and fatty degeneration in 18 patients and 15 patients, respectively. Researchers found a Constant score of 82 points in patients who had tears with no progression of atrophy vs. a Constant score of 75.5 points in patients who had tears with progression. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.