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Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis

Clinics in Shoulder and Elbow 2020년 23권 2호 p.86 ~ 93
Karasuyama Masaki, Gotoh Masafumi, Tahara Keiji, Kawakami Junichi, Madokoro Kazuya, Nagamatsu Takashi, Imai Takaki, Harada Nobuya, Kudo Yu, Shiba Naoto,
소속 상세정보
 ( Karasuyama Masaki ) - Kyushu Nutrition Welfare University Department of Physical Therapy
 ( Gotoh Masafumi ) - Kurume University Medical Center Department of Orthopedic Surgery
 ( Tahara Keiji ) - Tahara Orthopedic Clinic Department of Orthopedic Surgery
 ( Kawakami Junichi ) - Kyushu Nutrition Welfare University Department of Physical Therapy
 ( Madokoro Kazuya ) - Technical School of Medical and Welfare Ryokuseikan Department of Physical Therapy
 ( Nagamatsu Takashi ) - Kurume University School of Medicine Graduate School
 ( Imai Takaki ) - Keishinkai Hospital Department of Rehabilitation
 ( Harada Nobuya ) - Kurume University School of Medicine Graduate School
 ( Kudo Yu ) - Kurume University School of Medicine Graduate School
 ( Shiba Naoto ) - Kurume University Department of Orthopedic Surgery

Abstract


Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined.

Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate.

Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2º (2 months), 159.0º (6 months), 168.1º (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires “vitality” section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05).

Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.

키워드

Shoulder; Rotator cuff injuries; Conservative management

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