Abstract
Purpose
To analyse the current scientific evidence regarding the natural history of the clinical and anatomical progression of rotator cuff tears.
Methods
A broad systematic review of the literature (PubMed database through January 2014) which was guided, conducted and reported according to PRISMA criteria. This article focuses on the rotator cuff tears. Articles had to meet an inclusion criteria. The methodological quality of each study was individually assessed using a recently developed general assessment tool AMQPP (assessing the methodological quality of published papers).
Results
Seven articles dealing with rotator cuff tears were included, one of them was a high-quality study. Three papers assessed the natural history and the natural course of rotator cuff rupture directly. The other studies indirectly assessed the natural history with reports on non-operative and operative therapy trends. All of these articles had been published in four different top medical journals according to 2013 ranking. We found no articles which clearly referred to the role of regression to the mean of rotator cuff tears.
Conclusion
The development of symptoms and anatomical deterioration are often directly correlated. Spontaneous recovery to normal levels of function has been successfully achieved, and standardised non-operative treatment programmes are an effective alternative to surgery for many patients. Follow-up is necessary to avoid irreparable stage. However, surgery is still favoured by young active people and highly professional persons who need to get fit in a short period of time. Further research is still necessary. The AMQPP score system is simple and reliable. It works as a quick quality-checking tool which helps researchers to identify the key points in each paper and reach a decision regarding the eligibility of the paper more easily.
Similar content being viewed by others
References
Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ (2006) Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl 88(2):116–121
Baydar M, Akalin E et al (2009) The efficacy of conservative treatment in patients with full-thickness rotator cuff tears. Rheumatol Int 29(6):623–628. doi:10.1007/s00296-008-0733-2 Epub 2008 Oct 12
Codman (1911) Complete rupture of the supraspinatus tendon. Operative treatment with report of two successful cases. Boston Med Surg J 164:708–710
Moher D, Liberati et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. doi:10.1136/bmj.b2535
Greenhalgh T (1997) Assessing the methodological quality of published papers. BMJ 315(7103):305–308
Zingg PO, Jost B et al (2007) Clinical and structural outcomes of nonoperative management of massive rotator cuff tears. J Bone Joint Surg Am 89(9):1928–1934
Kuhn JE, Dunn WR et al (2013) Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg 22(10):1371–1379. doi:10.1016/j.jse.2013.01.026
DeVries JG, Berlet GC et al (2010) Understanding levels of evidence for scientific communication. Foot Ankle Spec 3(4):205–209. doi:10.1177/1938640010375184
Moosmayer S, Tariq R, Stiris M, Smith HJ (2013) The natural history of asymptomatic rotator cuff tears: a three-year follow-up of fifty cases. J Bone Joint Surg Am 95(14):1249–1255. doi:10.2106/JBJS.L.00185
Mall NA, Kim HM et al (2010) Symptomatic progression of asymptomatic rotator cuff tears: a prospective study of clinical and sonographic variables. J Bone Joint Surg Am 92(16):2623–2633. doi:10.2106/JBJS.I.00506
Safran O, Schroeder J, Bloom R, Weil Y, Milgrom C (2011) Natural history of nonoperatively treated symptomatic rotator cuff tears in patients 60 years old or younger. Am J Sports Med 39(4):710–714. doi:10.1177/0363546510393944
Goldberg BA, Nowinski RJ, Matsen FA 3rd (2001) Outcome of nonoperative management of full-thickness rotator cuff tears. Clin Orthop Relat Res 382:99–107
Fucentese SF, von Roll AL, Pfirrmann CW, Gerber C, Jost B (2012) Evolution of nonoperatively treated symptomatic isolated full-thickness supraspinatus tears. J Bone Joint Surg Am 94(9):801–808. doi:10.2106/JBJS.I.01286
Saha S, Saint S, Christakis DA (2003) Impact factor: a valid measure of journal quality. J Med Libr Assoc 91(1):42–46
Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M (1995) Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 77(2):296–298
Yamaguchi K, Tetro AM et al (2001) Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg 10(3):199–203
Brasseur JL, Zeitoun-Eiss D (2005) Ultrasound of acute disorders of the shoulder. JBR-BTR 88(4):193–199
Slabaugh MA, Nho SJ et al (2010) Does the literature confirm superior clinical results in radiographically healed rotator cuffs after rotator cuff repair? Arthroscopy 26(3):393–403. doi:10.1016/j.arthro.2009.07.023
Itoi E, Hatakeyama Y et al (2003) A new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study. J Shoulder Elbow Surg 12(5):413–415
Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS (1993) Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop Relat Res 294:103–110
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Eljabu, W., Klinger, H.M. & von Knoch, M. The natural history of rotator cuff tears: a systematic review. Arch Orthop Trauma Surg 135, 1055–1061 (2015). https://doi.org/10.1007/s00402-015-2239-1
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-015-2239-1