2017 ISAKOS Biennial Congress ePoster #2210

 

Timing of Repair in Degenerative Cuff Tears: How Long Can We Wait?

Ronald L. Diercks, Prof, MD, PhD, Groningen, Groningen NETHERLANDS
F. Okke Lambers Heerspink, MD, Groningen NETHERLANDS
Jos Van Raaij, MD, PhD, Groningen NETHERLANDS
Inge Van Den Akker-Scheek, PhD, Groningen, Groningen NETHERLANDS
Rob Derks, MD, Deventer, Overijssel NETHERLANDS
R. Westerbeek, MD, Deventer, Overijssel NETHERLANDS

Groningen University Medical Center, Groningen, Groningen, NETHERLANDS

FDA Status Not Applicable

Summary

T ear size, muscle atrophy and fatty infiltration do not increase within a year of conservative treatment of degenerative rotator cuff tears

Abstract

Results of conservative treatment of symptomatic degenerative rotator cuff tears report success rates of approximately 75%. Although this would stimulate a conservative approach to such tears, concern exists over tear progression over time. This might impair cuff reparability if conservative treatment fails. The goal of this study was to compare the changes in tear size, muscle atrophy and fatty infiltration after one year in patients randomized for conservative treatment or surgical repair.

Methods

We performed a prospective study in 41 patients with an MRI-proven degenerative full-thickness rotator cuff tear. Patients were included between January 2009 and December 2012. MRI was performed on inclusion and one year after inclusion. 19 patients were treated surgically and 22 conservatively (part of an RCT) . Changes in Warner, Goutallier and Patte scores, the tangent sign and the amount of retraction were compared between the three groups (intact repairs, retears and conservatively treated patients).

Results

At 12 months follow-up there were 5 patients with intact repairs, 14 patients with a retear or failed repair, and 22 patients had received conservative treatment. No significant changes in tear size, muscle atrophy or fatty infiltration of the rotator cuff were observed in the three study groups one year after inclusion.

Conclusion

This study provides evidence that in patients with a full-thickness symptomatic degenerative rotator cuff tear conservative treatment can be maintained during at least one year without jeopardizing cuff reparability.