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Functional outcomes after non-operative treatment of irreparable massive rotator cuff tears: Prospective multicenter study in 68 patients

Agout, Charles and Berhouet, Julien and Spiry, Clément and Bonnevialle, Nicolas and Joudet, Thierry and Favard, Luc Functional outcomes after non-operative treatment of irreparable massive rotator cuff tears: Prospective multicenter study in 68 patients. (2018) Orthopaedics & Traumatology: Surgery & Research, 104 (8). S189-S192. ISSN 1877-0568

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Official URL: https://doi.org/10.1016/j.otsr.2018.08.003

Abstract

BACKGROUND: Massive rotator cuff tears (RCTs) account for 10% to 40% of all RCTs and over 80% of re-tears. The objectives of this prospective study were to assess functional outcomes 6 and 12 months after starting non-operative therapy for an irreparable massive RCT and to identify predictors of good outcomes of non-operative treatment. HYPOTHESIS: Non-operative treatment deserves to be tried because it can produce improvements in patients with irreparable massive RCTs. MATERIAL AND METHODS: A prospective multicenter (12 centres) study was conducted between March 2015 and March 2016. Consecutive patients managed non-operatively for RCTs involving two or more tendons including one with a fatty infiltration score greater than 2 were included. Non-operative treatment consisted in rehabilitation and sub-acromial corticosteroid injections. Functional outcomes were assessed based on the Constant score and Subjective Shoulder Value (SSV) after 3, 6, and 12 months. RESULTS: Of 71 included patients, 3 underwent surgery during the study year, leaving 68 patients for the analysis of 12-month outcomes. Significant improvements were noted after 12 months in the Constant score (from 40.7 at baseline to 57.7 after 6 months and 57.1 after 12 months), in each of its items except force, and in the SSV. Constant score values after 6 and 12 months were not significantly different. No significant differences in functional outcomes were found across initial tear type. CONCLUSION: Non-operative treatment produces significant functional gains in patients with irreparable massive RCTs. These gains are obtained after 6 months. Surgery can therefore be considered if the outcome is unsatisfactory after 6 months.

Item Type:Article
HAL Id:hal-02135785
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Centre Hospitalier Régional Universitaire de Tours - CHU Tours (FRANCE)
Other partners > Clinique chirurgicale du Libournais (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
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Deposited On:19 Mar 2019 08:12

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