A new French study has revealed the benefits of early surgical intervention in isolated rotator cuff tears. According to the study’s findings, if surgery is performed early enough for supraspinatus tears, it helps to improve function and strength, amongst numerous other benefits.
Here, we’ll look at the findings which have been published in The Journal of Bone & Joint Surgery and what it means for patients.
Can the findings be trusted?
The study was conducted by an Orthopaedic Surgery Research Group in France and it followed a total of 511 patients. However, only 288 patients went on to have a follow-up, leading some experts to question the results.
The 511 patients had undergone surgery to repair full thickness supraspinatus tears in 2003. Results of the study were written up at a 10-year follow-up appointment. Out of the 288 patients who did go back for a follow-up, 210 received a magnetic resonance imaging (MRI) scan. This revealed the majority of patients had experienced significant improvement.
The standard Constant score was used to assess shoulder strength, motion, pain and daily activity abilities. In the majority of patients, their score had risen from an average 52 to 78. The scans also revealed around 80% of the tendons had healed, but there was still a minor residual tear found in most cases.
The follow-up also revealed patients who were found to have a build-up of fat in the repaired muscle didn’t heal and recover as well as those who didn’t. Fat build-up within the muscle is a sign of muscle degeneration.
Although the researchers themselves do admit there are limitations of the study due to the fact so many patients didn’t return for a follow-up, they still feel it provides a reliable analysis of how surgery could help to improve the outcome of supraspinatus tears. It’s certainly the longest-term study carried out to assess the benefits of surgery in isolated rotator cuff tears.
What are supraspinatus tears?
There are four major tendons within the rotator cuff of the shoulder, and the supraspinatus is one of them. It is also the most common type of rotator cuff tear patients suffer with. A tear, either partial or full-thickness, can occur because of a trauma, or through repeated micro-traumas.
The majority of full-thickness supraspinatus tears, tend to start out as partial tears and they worsen over time. This backs up the results of the French study in the fact surgery should be carried out early to prevent the condition worsening.
What treatment options are available?
Treatment is decided based upon the severity of the tear. Surgery currently tends to be used as a last resort. Instead, specialists prefer to start out with a physical therapy treatment plan; especially if the tear is only minor. This is because in the past, surgery was known to come with long, often painful recovery times.
However, surgical techniques have advanced and as the French study shows, surgery could be the most effective treatment for early supraspinatus tears. One thing all experts can agree on is the earlier a patient seeks treatment for this type of rotator cuff tear, the better the outcome will be.
Overall, the study’s findings are promising and they do give a good indication of the long-term success rates of early surgery in supraspinatus tears. It also showed the success rate remains the same regardless of whether open or closed surgical techniques are used.