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- Talk
- UK
Non-surgical Management of the Person with a Chronic Rotator Cuff Tear
Description
In this insightful presentation, Professor Chris Littlewood, a musculoskeletal research expert at Manchester Metropolitan University, evaluates the non-surgical management of chronic rotator cuff tears, particularly in patients over the age of 55. He highlights the prevalence of rotator cuff tears and the importance of distinguishing between symptomatic and asymptomatic cases, emphasizing that many individuals may harbor tears without exhibiting any pain or dysfunction. Chris discusses clinical guidelines advocating for non-surgical interventions, especially given the findings of recent systematic reviews showing comparable outcomes between surgical and physiotherapeutic treatments.
He notes the significant cost differences, where surgery can range from £2,900 to £5,600 compared to physiotherapy costs of around £204 for several sessions, reinforcing the economic case for conservative management. While acknowledging the potential for surgical repair to improve structural integrity, he also points out the substantial re-tear rates associated with surgery, which can reach as high as 40%.
The presentation elaborates on the necessity of setting realistic expectations with patients regarding rehabilitation timelines and the challenges they may face. Chris underscores the crucial impact of language and patient beliefs about their treatment options on their engagement with physiotherapy.
Ultimately, he advocates for the continued exploration of non-surgical pathways and encourages ongoing discussion about the best management strategies, emphasizing the complexity of rotator cuff tears and the ongoing need for research in this field. His conclusion suggests that while non-surgical management is well-supported, significant questions persist around treatment pathways and their effectiveness, particularly when considering the natural progression of rotator cuff injuries.