RESULTS OF NONOPERATIVE MANAGEMENT OF FULL-THICKNESS TEARS OF THE ROTATOR CUFF

The results of nonoperative management of 53 patients with full-thickn ess tears of the rotator cuff proven by arthroscopic examination was a s follows. Patients were treated with nonsteroidal antiinflammatory me dication, stretching, strengthening, and occasional steroid injections . Average age at presentation was 62.2 years. Patients were evaluated at an average of 7.6 years. Forty patients were male, and the dominant limb was involved in 40 cases. Thirty-four patients were reviewed by questionnaire and physical examination, whereas 19 patients were evalu ated by telephone interview only. In 40 patients, the onset of symptom s was associated with an injury. In 12 patients, workmen's compensatio n was involved. At follow-up evaluation, the 34 shoulders that were av ailable for examination were evaluated for pain, range of motion, stre ngth, and function. Thirty-nine of the 53 patients (74%) assessed subj ectively had only slight or no shoulder discomfort. Of the 28 shoulder s presenting within three months of injury, 24 (86%) were rated as sat isfactory at the time of latest evaluation. Of the 16 patients who ini tially had had shoulder pain for over 6 months, only nine (56%) were r ated as satisfactory. Most patients showed improvement with regard to their ability to perform activities of daily living. Average active to tal elevation was 149-degrees compared with 121-degrees at initial pre sentation. Thirty-two of the 34 patients examined (94%) had evidence o f weakness on muscle testing and 19 (56%) had demonstrable muscle atro phy.