The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears

• Published in: Journal of shoulder and elbow surgery Vol. 17; no. 6; pp. 863 - 870
• Main Authors: Levy, Ofer, MD, MCh(Orth), Mullett, Hannan, FRCS(TR & Orth), Roberts, Sarah, Bsc(Hons), Bed(Hons), MCSP, Copeland, Stephen, FRCS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.2008; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Diseases of the osteoarticular system; Exercise Therapy; Female; Humans; Juxtaarticular diseases. Extraarticular rhumatism; Magnetic Resonance Imaging; Male; Medical sciences; Miscellaneous; Muscle Contraction - physiology; Muscle Strength; Muscle, Skeletal - physiopathology; Orthopedics; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of Motion, Articular; Rotator Cuff - pathology; Rotator Cuff Injuries; Rupture; Shoulder Joint - physiopathology; Treatment Outcome; Juxtaarticular disease; Human; Reeducation; Rotator cuff rupture; Diseases of the osteoarticular system; Rheumatology
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2008.04.005

The management of massive rotator cuff tears in medically unfit, elderly patients is difficult. We prospectively assessed 17 patients with radiologically confirmed, nontraumatic, massive rotator cuff tears who were treated with an anterior deltoid rehabilitation program. All patients were medically unfit, with an average age of 80 years (range, 70-96 years). Patients were given standard detailed instruction and an illustrated guide. A video recording of shoulder motion was made before and after treatment. The Constant score increased from a mean of 26 (range, 8-41) before treatment to a mean of 60 (range, 43-77) at a minimum of 9 months after treatment. Range of motion in forward elevation improved from a mean of 40° (range, 30°-60°) at presentation to a mean of 160° (range 150°-180°) after the deltoid rehabilitation course. We recommend that a structured deltoid rehabilitation program is suitable for elderly patients with massive rotator cuff tears.