Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Serial Magnetic Resonance Imaging to Determine the Progression of Neglected Recalcitrant Rotator Cuff Tears: A Retrospective Multicenter Study

  • Yoo, Yon-Sik (Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Park, Jin-Young (Global Center for Shoulder, Elbow and Sports at Neon Orthopaedic Clinic) ;
  • Choi, Chang-Hyuk (Department of Orthopedic Surgery, Catholic University of Daegu School of Medicine) ;
  • Cho, Nam-Su (Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong) ;
  • Cho, Chul-Hyun (Department of Orthopedic Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lim, Tae-Gang (Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University) ;
  • Sim, Sang-Don (Department of Orthopedic Surgery, Donga Hospital) ;
  • Rhie, Tae-Yon (Department of Orthopaedic Surgery, Nalgae Hospital) ;
  • Lee, Ho Won (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital) ;
  • Jung, Jong Ho (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital) ;
  • Lee, Yong-Beom (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital)
  • Received : 2017.02.07
  • Accepted : 2017.08.15
  • Published : 2017.09.30
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Abstract

Background: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. Methods: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. Results: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. Conclusions: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.

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References

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