Abstract Presented at the 26th Annual Meeting of the Arthroscopy Association of North America| Volume 23, ISSUE 6, SUPPLEMENT , e12-e13, June 2007

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The Operative Management of Rotator Cuff Disease Results in Superior Pain Relief and Functional Improvement Compared to Non-operative Treatment (SS-24)


      Using validated outcome instruments, this study indicates that operative treatment of rotator cuff disease results in greater pain relief and functional improvement than non-operative treatment.


      To compare the outcomes of operative and non-operative treatment in patients with rotator cuff disease using validated, patient-derived outcome instruments.


      All patients with a diagnosis of rotator cuff disease over a 5-year period (2000-2005) were surveyed using a questionnaire which included the validated patient-derived outcome assessment instruments: SF-36, Euroqol (EQ), VAS, ASES (American Shoulder and Elbow Surgeons) score, and SST (Simple Shoulder Test). Non-operative treatment consisted of NSAIDs, corticosteroid injections, and physical therapy. Operative treatment included arthroscopic acromioplasty and rotator cuff repair when indicated. Of the patients with completed questionnaires and minimum one-year follow-up data, 90 patients (92 shoulders) who underwent operative treatment of rotator cuff disease were demographically matched by age and gender with 90 patients who underwent non-operative treatment. Statistical analysis was performed using a paired student’s t-test.


      At minimum one year follow-up (average 2.9±1.3 years), improvement in pain relief (percent reduction) was significantly better in the operative group than non-operative group (VAS 42.8% v. 23.9%, p<0.05). Functional improvement (percent increase) was also significantly better in the operative group relative to the non-operative group (SST 40.7% v. 20.5%, ASES function 40.3% v. 23.6%, p<0.05). No statistically significant differences were observed post-treatment in quality of life scores (Euroqol, SF-36, Health Scale), although patients who elected surgical treatment had a greater percent improvement at follow-up (22.6% v. 9.8%, p<0.05).


      The present study supports the success of both operative and non-operative treatment of rotator cuff disease using validated outcome instruments and quality of life scores. Results from operative treatment were superior to non-operative treatment in both pain relief and functional improvement. These findings may have significant impact on the decision between operative and non-operative treatment in rotator cuff disease.