Journal article
2024 Kappa Delta Ann Doner Vaughan Award Nonsurgical Treatment of Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears-a Prospective Multicenter Cohort Study With 10-Year Follow-Up
Journal of the American Academy of Orthopaedic Surgeons, Vol.32(23), pp.1061-1073
12/01/2024
DOI: 10.5435/JAAOS-D-24-00841
PMID: 39325825
Abstract
The Multicenter Orthopaedic Outcomes Network Shoulder Group conducted a prospective cohort study of 452 patients with symptomatic atraumatic rotator cuff tears treated with a physical therapy program to determine the predictors of failure of nonsurgical treatment, to provide insight into indications for surgery. After 10 years, we found the following: (1) Physical therapy was effective for over 70% of patients. (2) PROMs showed statistical and clinical improvement after 12 weeks of therapy and did not decline over 10 years. (3) Cuff tear severity did not correlate with pain, duration of symptoms, or activity level. (4) Of those who had surgery, 56.7% had surgery in the first 6 months while 43.3% had surgery between 6 months and 10 years. (5) Early surgery was primarily driven by low patient expectations regarding the effectiveness of therapy. (6) Later surgery predictors included workers' compensation status, activity level, and patient expectations. (7) Only 1 patient had a reverse arthroplasty (0.2% of the cohort). These data suggest that physical therapy is an effective and durable treatment of atraumatic symptomatic rotator cuff tears and most patients successfully treated with physical therapy do not exhibit a decline in patient-reported outcomes over time. Reverse arthroplasty after nonsurgical treatment is exceptionally rare.
Details
- Title: Subtitle
- 2024 Kappa Delta Ann Doner Vaughan Award Nonsurgical Treatment of Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears-a Prospective Multicenter Cohort Study With 10-Year Follow-Up
- Creators
- John E Kuhn - Vanderbilt University Medical CenterWarren R DunnRosemary Sanders - Vanderbilt University Medical CenterKeith M Baumgarten - Orthopedic InstituteJulie Y Bishop - The Ohio State UniversityRobert H Brophy - Washington University in St. LouisJames L Carey - University of PennsylvaniaBrian G HollowayGrant L Jones - The Ohio State UniversityC Benjamin Ma - University of California, San FranciscoRobert G Marx - Hospital for Special SurgeryEric C McCarty - Hospital for Special SurgerySourav K Poddar - Hospital for Special SurgeryMatthew V Smith - Washington University in St. LouisEdwin E SpencerArmando F Vidal - Steadman ClinicBrian R Wolf - University of IowaRick W Wright - Vanderbilt University Medical CenterMulticenter Orthopaedic Outcomes Network (MOON) Shoulder Group
- Resource Type
- Journal article
- Publication Details
- Journal of the American Academy of Orthopaedic Surgeons, Vol.32(23), pp.1061-1073
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- DOI
- 10.5435/JAAOS-D-24-00841
- PMID
- 39325825
- ISSN
- 1067-151X
- eISSN
- 1940-5480
- Grant note
- 5K23-AR05392-05 / NIAMSD na / Arthrex
- Language
- English
- Electronic publication date
- 09/24/2024
- Date published
- 12/01/2024
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984720459902771
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