Massive Retracted Irreparable Rotator Cuff Tears: What Is the Effect of Conservative Therapy?

Abstract

Introduction: Massive, irreparable, retracted cuff tears, without surgical intervention need to be treated with conservative therapy. In this study we aimed to determine the efficacy of conservative treatment in such tears. Material and Methods: We retrospectively reviewed 33 patients with massive rotator cuff tears treated nonoperatively. Data were obtained from direct examination, medical records, plain radiographs, and magnetic resonance imaging (MRI). Radiographic classification has been made by plain AP views. The fatty muscle degeneration and the stage of retraction of the cuff were evaluated with MRI. Rehabilitation program was given to all patients. Results: The mean age at the initial examination was 71 (range, 50-84) years. The mean follow-up time was 5.5 (range, 2-10) years. Patients with Grade 3-5 tears and Stage III retractions had a higher incidence of fatty muscle degeneration of the subscapularis muscle. Deltoid muscle strength was found to be increased significantly at the latest follow-up. Conclusion: Exercise therapy should be kept in mind as a kind of rehabilitation method in patients with a symptomatic massive rotator cuff tear. It's essential that more randomised clinical investigations have to be conducted to find out the best management practice for this condition.