Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct 30;1(1):12-9.
Print 2011 Jan.

Conservative management of rotator cuff tears: literature review and proposal for a prognostic. Prediction Score

Giovanni Merolla  1 , Paolo Paladini, Marco Saporito, Giuseppe Porcellini
Affiliations

Conservative management of rotator cuff tears: literature review and proposal for a prognostic. Prediction Score

Giovanni Merolla et al. Muscles Ligaments Tendons J. .

Abstract

Rotator cuff tears are a common cause of pain and shoulder dysfunction. The prevalence of the rotator cuff tears increases with the age reaching the 80% in patients aged more than 80 year. Symptomatic shoulders usually are initially treated conservatively and then, in case of poor outcomes, with surgery. Different parameters are still used to decide between the conservative or surgical treatment in patients with rotator cuff tears. Aim of the current study is to characterize the various features used in decision making and to validate a "Prediction Score" that let us know which patients could have a good and stable outcome with non operative treatment. We enrolled 60 patients (mean age 52 years) with symptomatic rotator cuff tears who were assigned to conservative treatment and were evaluated at 6,9 and 12 months follow-up. We developed a score based on 18 clinical and radiographic parameters. 27 patients ("non conservative") (45%) with a mean prediction score of 16.1 ± 1.7 interrupted the conservative treatment, while 33 patients ("conservative") (55%) with an average prediction score of 11.3 ± 1.8 remained conservatively treated at last follow-up. The conservative patients were 14 years older than non conservative patients. According to the results of this study we identified a value of 13 points as a "cut-off" score to predict good results by conservative management of rotator cuff tear. These outcomes support the assumption that a predictive prognostic score may guarantee a rational approach in the management of subjects with RC tears, especially in elderly who continue to have the higher rate of recurrence and therefore could be well treated with standard conservative therapies.

Keywords: conservative treatment; prediction score; rotator cuff; shoulder.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A–B Clinical assessment of “drop sign”. When the examiner place the shoulder at 45° of external rotation (A) and it drop back to 0° (B) the test is positive.
Figure 2
Figure 2
Patient’s position to evaluate scapular dyskinesis.
Figure 3
Figure 3
Constant-Murley score of the study population at all three follow-ups.
Figure 4
Figure 4
Course of pain score in the “conservative” and “non conservative” subjects from baseline to 12 months
See this image and copyright information in PMC

References

    1. Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199–203. - PubMed
    1. Schibany N, Zehetgruber H, Kainberger F, Wurnig C, Ba-Ssalamah A, Herneth AM, Lang T, Gruber D, Breitenseher MJ. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study. Eur J Rad. 2004;5:236–238. - PubMed
    1. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulder. J Bone Joint Surg Am. 1995;77:10–15. - PubMed
    1. Milgrom C, Schaffler M, Gilbert S, Van Holsbeeck M. Rotator cuff changes in asymptomatic adults: The effect of age, hand dominance and gender. Journal Bone Joint Surg Br. 1995;77:296–298. - PubMed
    1. Kelly BT, Williams RJ, Cordasco FA, Backus SI, Otis JC, Weiland DE, Altchek DW, Craig EV, Wickiewicz TL, Warren RF. Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears. J Shoulder Elbow Surg. 2005;14:165–171. - PubMed

LinkOut - more resources