Non-surgical treatment is equivalent to surgical treatment even after unsuccessful initial rehabilitation in people with RCD without full-thickness tendon tear.<\/p>\n
INTRODUCTION<\/strong> Recent studies show that a type of surgery called subacromial decompression and non-surgical treatments WHAT DID THE AUTHORS HOPE TO FIND?<\/strong> WHO WAS STUDIED?<\/strong> HOW WAS THE STUDY CONDUCTED?<\/strong> WHAT WERE THE MAIN FINDINGS OF THE STUDY?<\/strong> ARE THESE FINDINGS NEW?<\/strong> WHAT ARE THE LIMITATIONS OF THE STUDY?<\/strong> WHAT DO THE AUTHORS PLAN ON DOING WITH THIS INFORMATION?<\/strong> WHAT DOES THIS MEAN FOR ME?<\/strong> If you have any concerns about your disease or its treatment, you should talk to your doctor.<\/p>\n Disclaimer:<\/strong> This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefor every important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Please view our full Website Terms and Conditions. http:\/\/www.bmj.com\/company\/legal-information\/ Summary based on research article published on:<\/strong> 3 December 2020 Copyright<\/strong> \u00a9 2021 BMJ Publishing Group Ltd & European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our Rights and Licensing Team<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":" Non-surgical treatment is equivalent to surgical treatment even after unsuccessful initial rehabilitation in people with RCD without full-thickness tendon tear. INTRODUCTION The rotator cuff is a group of muscles and tendons that surrounds the shoulder joint. Rotator cuff disease (shortened to RCD) is very common and is usually caused by tendon degeneration. RCD may also […]<\/p>\n
\nThe rotator cuff is a group of muscles and tendons that surrounds the shoulder joint. Rotator cuff disease (shortened to RCD) is very common and is usually caused by tendon degeneration. RCD may also be associated with an injury. In either case, it causes prolonged shoulder pain and disability in adults. There is a spectrum of RCD, ranging from tendinopathy to full-thickness tendon tear.<\/p>\n
\nprovide the same results in people with RCD without full-thickness tendon lesion. The importance of surgery for full-thickness tendon tears remains unclear.<\/p>\n
\nThe authors wanted to answer a question frequently asked by GPs, rheumatologists and orthopaedic surgeons: how should I treat a person with RCD?<\/p>\n
\nThe study looked at 417 people with long-term shoulder pain lasting more than 3 months. Everyone was
\nreferred from primary and occupational healthcare centres and private clinics to the one of two study hospitals in Finland.<\/p>\n
\nThis was a pragmatic, randomised, controlled trial. Everyone with subacromial pain had an MRI image done to confirm the diagnosis of RCD and underwent a 3-month initial rehabilitation. After this time, 190 shoulders still had symptoms, and these people were randomised to non-surgical or surgical treatments. The primary outcome was the mean change in shoulder pain and function after 2 years.<\/p>\n
\nThe main finding was that non-surgical and surgical treatments for RCD provided equivalent improvements in pain and function.<\/p>\n
\nYes. There have been previous studies, but none have looked at the same thing. This study focused on surgery after adequately performed \u2013 but unsuccessful \u2013 non-surgical treatment of RCD including both non-full-thickness and full-thickness tendon lesions. In this trial, all potential participants underwent a structured, 3-month rehabilitation before randomisation to ensure that only symptomatic patients were included.<\/p>\n
\nThe two main limitations are that this study did not have a placebo surgery group, and the study physiotherapists were not blinded \u2013 meaning they knew which treatment people had received. Also, 26% of people were not treated as planned. This is because some people were randomised then decided not to undergo surgery, and some were randomised to non-surgical treatment but later wanted surgery due to severe pain.<\/p>\n
\nThe authors plan to do a longer follow-up to clarify whether non-surgical or surgical treatment is the best option for RCD. Their 5-year follow-up results will be reported later.<\/p>\n
\nIf you have RCD, the best choice will be made in discussion with your doctor. The authors of this paper recommend non-surgical treatment as the primary choice. However, surgery can give superior improvement in pain and function for people with a full-thickness rotator cuff rupture. Therefore, rotator cuff tendon repair may be suggested if non-surgical treatment does not work for you.<\/p>\n
\nDate prepared: May 2021<\/p>\n
\nFrom:<\/strong> Cederqvist S, et al<\/em>. Non-surgical and surgical treatments for rotator cuff disease: a pragmatic randomised clinical trial with 2-year follow-up after initial rehabilitation. Ann Rheum Dis<\/em> 2021;80:796\u2013802. doi:10.1136\/annrheumdis-2020-219099<\/p>\n