The Cochrane review of Coghlan et al. (2008) on surgery included 2 RCTs on RotCuffTear. Both RCTs scored 3 of the 6 items positive (in both studies the randomization was adequate
and the patients were blinded), and 3 items as unclear (in Selleckchem Crizotinib both studies the concealment of allocation and blinding of the outcome assessor was unclear). According to Coglan et al. these RCTs are of low quality. For all included RCTs (recent, additional and included in the Cochrane reviews) the concealment of the allocation and intention-to-treat was assessed and was scored positive in about 50%. Table 3 showed an overview of the evidence found for effectiveness of interventions to treat RotCuffTears. Buchbinder et al. (2003) studied the effectiveness of corticosteroid injections for shoulder pain.
Only one low-quality RCT (Shibata et al., 2001) reported on RotCuffTears: 78 full-thickness RotCuffTears were treated with intra-articular corticosteroid or hyaluronate injections. After 4 weeks, no significant differences regarding satisfaction with improvement due to the treatment were found. We conclude that there is no evidence for the effectiveness of corticosteroid injections in the short-term (4 weeks). As mentioned above, the Cochrane review of Selleckchem AZD2281 Ejnisman et al. (2004) examined non-surgical and surgical interventions for RotCuffTears. Eight trials (n = 455) were included. Data of 393 patients were analysed. One high-quality study ( Vecchio
et al., 1993) reported on the effectiveness of a suprascapular nerve block with dexamethasone versus placebo in 13 patients with a persistent rotator cuff lesion. At 12-weeks follow-up, night pain and pain with movement, and active abduction, flexion and external rotation were better in the treatment group. No comparisons between the groups were made. Therefore, we found no evidence for the effectiveness a suprascapular nerve block with dexamethosone versus placebo Interleukin-3 receptor for treating the RotCuffTear in the short-term. A high-quality study (Moosmayer et al., 2010) (n = 103) studied the effectiveness of surgery (mini-open or open rotator cuff repair INS> (RCR)) versus physiotherapy (exercise therapy) and found significant differences between the groups in favour of surgery on the Constant Score at 12-months follow-up (13.0 (95% CI 4.9–21.1)) but not at 6-months follow-up. On the ASES score significant differences between the groups were found in favour of surgery at 6-months (11.4 (95% CI 3.6–19.1)) and 12-months (16.1 (95% CI 8.2–23.9)) follow-up. We conclude that there is moderate evidence that surgery is more effective than physiotherapy (exercise therapy) in patients with RotCuffTears in the mid- and long-term. The Cochrane review of Coghlan et al. (2008) studied surgery for rotator cuff disease and included 14 studies. Two of these (Gartsman and O’Connor, 2004 and Boehm et al., 2005) reported on interventions for RotCuffTear.