Journal of shoulder and elbow surgery · 2017
Anterior deltoid reeducation for irreparable rotator cuff tears revisited.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Yian Edward H, Sodl Jeffrey F, Dionysian Emil, Schneeberger Alberto G
Аннотация
BACKGROUND: A previous study introduced a method of conservative treatment of irreparable rotator cuff tears (RCTs) using a rehabilitation program (anterior deltoid reeducation [ADR]). The purposes of this study were to present our experience with ADR and to compare our results with those of the previous study.
METHODS: Thirty consecutive elderly patients with irreparable RCTs were prospectively enrolled and taught how to perform the home-based ADR program for a period of 3 months. Clinical and radiographic evaluations were determined at the first visit. Clinical follow-up was available after 9 and 24 months. Failure of the ADR program was defined as abandonment of the ADR program because of pain and/or a patient's decision to undergo surgery at any time or a less than 20-point improvement in the American Shoulder and Elbow Surgeons score at last follow-up.
RESULTS: Of the 30 patients, 9 did not complete the 3-month ADR program because of pain. Of the 21 patients who completed the ADR program, 3 were not satisfied with the outcome and went on to undergo surgery. Eighteen of the 30 patients completed the program and had a follow-up at 24 months. Among these 18 cases, there were significant mean improvements between pre-ADR and follow-up outcome scores among all variables (P < .005). However, 6 of these 18 patients did not have an improvement in the American Shoulder and Elbow Surgeons score by at least 20 points. Overall, the ADR program had a success rate of only 40%.
CONCLUSION: A 3-month ADR program had limited success to treat irreparable RCTs. We could not reproduce the high rate of satisfactory results of 82% found in a previous study.
METHODS: Thirty consecutive elderly patients with irreparable RCTs were prospectively enrolled and taught how to perform the home-based ADR program for a period of 3 months. Clinical and radiographic evaluations were determined at the first visit. Clinical follow-up was available after 9 and 24 months. Failure of the ADR program was defined as abandonment of the ADR program because of pain and/or a patient's decision to undergo surgery at any time or a less than 20-point improvement in the American Shoulder and Elbow Surgeons score at last follow-up.
RESULTS: Of the 30 patients, 9 did not complete the 3-month ADR program because of pain. Of the 21 patients who completed the ADR program, 3 were not satisfied with the outcome and went on to undergo surgery. Eighteen of the 30 patients completed the program and had a follow-up at 24 months. Among these 18 cases, there were significant mean improvements between pre-ADR and follow-up outcome scores among all variables (P < .005). However, 6 of these 18 patients did not have an improvement in the American Shoulder and Elbow Surgeons score by at least 20 points. Overall, the ADR program had a success rate of only 40%.
CONCLUSION: A 3-month ADR program had limited success to treat irreparable RCTs. We could not reproduce the high rate of satisfactory results of 82% found in a previous study.