Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis. 2020

Masaki Karasuyama, and Masafumi Gotoh, and Keiji Tahara, and Junichi Kawakami, and Kazuya Madokoro, and Takashi Nagamatsu, and Takaki Imai, and Nobuya Harada, and Yu Kudo, and Naoto Shiba
Department of Physical Therapy, Kyushu Nutrition Welfare University, Kitakyushu, Japan.

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.

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