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Partial-thickness rotator cuff tears: clinical and imaging outcomes and prognostic factors of successful nonoperative treatment

Authors Lo IK, Denkers MR, More KD, Nelson AA, Thornton GM, Boorman RS

Received 4 October 2017

Accepted for publication 1 June 2018

Published 18 September 2018 Volume 2018:9 Pages 191—197

DOI https://doi.org/10.2147/OAJSM.S153236

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Andreas Imhoff


Ian K Lo,1 Matthew R Denkers,2 Kristie D More,1 Atiba A Nelson,1 Gail M Thornton,1 Richard S Boorman1

1Department of Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 2Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada

Purpose: The purpose of this study was to determine the clinical success rate of nonoperative treatment of partial-thickness rotator cuff tears (PT-RCTs), to determine baseline clinical factors predictive of outcome of nonoperative treatment of PT-RCTs, and to determine the imaging outcome of nonoperative treatment of PT-RCTs.
Patients and methods: All patients with a primary diagnosis of a PT-RCT were eligible for inclusion. Seventy-six patients (48 males, 28 females) with an average age of 52±10 years were included in the study. Patients were evaluated using a standardized format including clinical, imaging, and shoulder specific quality-of-life outcomes. Patients were assessed and treated either successfully nonoperatively or consented to undergo surgical intervention of their PT-RCT. Patients treated nonoperatively underwent follow-up by MRI arthrogram.
Results: Thirty-seven patients (49%) underwent nonoperative treatment. Logistic regression analysis indicated that the baseline variables of side (dominant or nondominant side involved), onset (traumatic or atraumatic), and thickness of tendon tear (<50% or >50%) were significant predictors of outcome. At a mean 46±7 months of follow-up, nonoperatively treated patients demonstrated a mean American Shoulder and Elbow Surgeons score of 85.1±16.0, and a Simple Shoulder Test score of 10.0±2.5. Overall, 76% of tears treated nonoperatively did not show a tear progression on anatomic imaging. Nine patients (24%) demonstrated tear progression, of which three patients (8%) demonstrated full-thickness tearing.
Conclusion: Nonoperative treatment was utilized in ~50% of the patients and resulted in improved clinical outcomes. Onset, shoulder involved, and thickness of the tear were predictive of the success of nonoperative treatment.

Keywords: magnetic resonance imaging follow-up, nonoperative, partial-thickness rotator cuff tears, rotator cuff

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