التفاصيل البيبلوغرافية
| العنوان: |
Non-surgical and surgical treatments for rotator cuff disease: a pragmatic randomised clinical trial with 2-year follow-up after initial rehabilitation. |
| المؤلفون: |
Cederqvist, Sanna, Flinkkilä, Tapio, Sormaala, Markus, Ylinen, Jari, Kautiainen, Hannu, Irmola, Tero, Lehtokangas, Heidi, Liukkonen, Juho, Pamilo, Konsta, Ridanpää, Tero, Sirniö, Kai, Leppilahti, Juhana, Kiviranta, Ilkka, Paloneva, Juha |
| المصدر: |
Annals of the Rheumatic Diseases; Jun2021, Vol. 80 Issue 6, p796-802, 7p |
| مصطلحات موضوعية: |
SHOULDER pain, RESEARCH, ARTHROSCOPY, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, RANDOMIZED controlled trials, ROTATOR cuff, LONGITUDINAL method |
| مستخلص: |
Background: Rotator cuff disease (RCD) causes prolonged shoulder pain and disability in adults. RCD is a continuum ranging from tendinopathy to full-thickness tendon tear. Recent studies have shown that subacromial decompression and non-surgical treatments provide equivalent results in RCD without a full-thickness tendon lesion. However, the importance of surgery for full-thickness tendon tears remains unclear.Methods: In a pragmatic, randomised, controlled trial, 417 patients with subacromial pain underwent 3-month initial rehabilitation and MRI arthrography (MRA) for the diagnosis of RCD. Of these, 190 shoulders remained symptomatic and were randomised to non-surgical or surgical treatments. The primary outcomes were the mean changes in the Visual Analogue Scale for pain and the Constant Murley Score for shoulder function at the 2-year follow-up.Results: At the 2-year follow-up, both non-surgical and surgical treatments for RCD reduced pain and improved shoulder function. The scores differed between groups by 4 (95% CI -3 to 10, p=0.25) for pain and 3.4 (95% CI -0.4 to 7.1, p=0.077) for function. Among patients with full-thickness ruptures, the reduction in pain (13, 95% CI 5 to 22, p=0.002) and improvement in function (7.0, 95% CI 1.8 to 12.2, p=0.008) favoured surgery.Conclusions: Non-surgical and surgical treatments for RCD provided equivalent improvements in pain and function. Therefore, we recommend non-surgical treatment as the primary choice for patients with RCD. However, surgery yielded superior improvement in pain and function for full-thickness rotator cuff rupture. Therefore, rotator cuff repair may be suggested after failed non-surgical treatment.Trial Registration Details: ClinicalTrials.gov, NCT00695981 and NCT00637013. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
