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Rotatorcuff skade

Sist revidert:
Sist revidert av:


Definisjon:
Rift, ruptur eller svikt i en eller flere av rotatorcuffens sener (komplett/inkomplett) forårsaket av traume eller overbelastning
Forekomst:
Patologi knyttet til rotatorcuffen er den vanligste årsaken til at det oppsøkes hjelp for skuldersmerter
Symptomer:
Symptomene ved skade på rotatorcuffen gir smerte og vansker med å elevere eller rotere armen
Funn:
Kliniske funn er ev. atrofi av affisert muskel, redusert aktiv bevegelse, smertebue, nedsatt kraft ved isometrisk test
Diagnostikk:
MR er den foretrukne undersøkelsen
Behandling:
Vanligvis konservativ behandling initialt, men særlig unge personer med fulltykkelsesruptur bør vurderes for primær kirurgisk intervensjon (6-8 uker)
  1. Malanga GA. Rotator cuff injury. Medscape, last updated Aug 28, 2017. emedicine.medscape.com  
  2. Simons SM, Dixon JB, Kruse D. Presentation and diagnosis of rotator cuff tears. UpToDate, last updated Jan 18, 2017. www.uptodate.com  
  3. Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med. 2012 Oct;31(4):589-604. doi: 10.1016/j.csm.2012.07.001. Epub 2012 Aug 30. PMID: 23040548. PubMed  
  4. Aune AK. Akutte skulderskader. I: Idrettsskader. Bahr R, Mæhlum S (red.). Oslo: Gazette bok, 2003.
  5. Mantone JK, Burkhead WZ Jr, Noonan J Jr. Nonoperative treatment of rotator cuff tears. Orthop Clin North Am 2000; 31: 295-311. PubMed  
  6. Gosk J, Urban M, Rutowski R. Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. Ortop Traumatol Rehabil 2007; 9: 68-74. PubMed  
  7. Wei AS, Callaci JJ, Juknelis D, et al. The effect of corticosteroid on collagen expression in injured rotator cuff tendon. J Bone Joint Surg Am 2006; 88: 1331-8. PubMed  
  8. Matsen FA. Rotator-cuff failure. N Engl J Med 2008; 358: 2138-47. PubMed  
  9. Largacha M, Parsons IM IV, Campbell B, Titelman RM, Smith KL, Matsen F III. Deficits in shoulder function and general health associated with sixteen common shoulder diagnoses: a study of 2674 patients. J Shoulder Elbow Surg 2006; 15: 30-9. PubMed  
  10. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006; 88: 1699-1704. PubMed  
  11. Zanetti M, Jost B, Hodler J, Gerber C. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects. Skeletal Radiol 2000; 29: 314-9. PubMed  
  12. Avdeling for allmennmedisin, Universitetet i Oslo. Trygg på skulder i primærhelsetjenesten. Faglig veileder. Publisert mars 2019. Nettsiden besøkt 16.04.19. www.helsebiblioteket.no  
  13. Barth JR, Burkhart SS, De Beer JF. The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy. 2006 Oct;22(10):1076-84. PMID: 17027405. PubMed  
  14. Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 2000; 82: 505-15. PubMed  
  15. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 2007; 35: 719-28. PubMed  
  16. Dunn WR, Schackman BR, Walsh C et al. Variation in orthopaedic surgeons' perceptions about the indications for rotator cuff surgery. J Bone Joint Surg Am 2005; 87: 1978-84. PubMed  
  17. Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NCA, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD009020. DOI: 10.1002/14651858.CD009020.pub2. DOI  
  18. Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of Nontraumatic Rotator Cuff Tears: A Randomized Controlled Trial with Two Years of Clinical and Imaging Follow-up. J Bone Joint Surg Am. 2015 Nov 4;97(21):1729-37. PubMed  
  19. Piper CC, Hughes AJ, Ma Y, et al. Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2017 Nov 21. pii: S1058-2746(17)30628-6. doi: 10.1016/j.jse.2017.09.032. (Systematic Review) PMID: 29169957 PubMed  
  20. Teefey SA, Rubin DA, Middleton WD et al. Detection and quantification of rotator cuff tears: comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am 2004; 86-A: 708-16.
  21. DeBerardino TM, Arciero RA, Taylor DC, Uhorchak JM. Prospective evaluation of arthroscopic stabilization of acute, initial anterior shoulder dislocations in young athletes. Two- to five-year follow-up. Am J Sports Med 2001; 29: 586-92. PubMed  
  22. Martin SD, Martin TL. Management of rotator cuff tears. UpToDate, last updated Sep 29, 2015. UpToDate  
  23. Moosmayer S, Lund G, Seljom U, et al. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff. J Bone Joint Surg Br 2010; 92: 83-91. PubMed  
  24. Moosmayer S, Lund G, Seljom US, et al. Tendon repair compared with physiotherapy in the treatment of rotator cuff tears: a randomized controlled study in 103 cases with a five-year follow-up. J Bone Joint Surg Am. 2014 Sep 17;96(18):1504-14. PubMed  
  25. Moosmayer S, Lund G, Seljom US, et al. At a 10-Year Follow-up, Tendon Repair Is Superior to Physiotherapy in the Treatment of Small and Medium-Sized Rotator Cuff Tears. J Bone Joint Surg Am. 2019 Jun 19;101(12):1050-1060. PMID: 31220021 PubMed  
  26. Ramme A, Robbins C, Patel K, et al. Surgical Versus Nonsurgical Management of Rotator Cuff Tears: A Matched-Pair Analysis. J Bone Joint Surg Am. 2019; 101: 1775-82. pmid:31577683 PubMed  
  27. Boudreault J, Desmeules F, Roy JS, et al. The efficacy of oral non-steroidal anti-inflammatory drugs for rotator cuff tendinopathy: a systematic review and meta-analysis. J Rehabil Med. 2014 ;46(4):294-306. doi: 10.2340/16501977-1800.
  28. Hanratty CE, McVeigh JG, Kerr DP, et al. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Seminars in Arthritis and Rheumatism 2012; 42(3): 297-316. pmid: 22607807 PubMed  
  29. Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg 2009; 18: 138-60. PubMed  
  30. Morse K, Davis AD, Afra R, Kaye EK, Schepsis A, Voloshin I. Arthroscopic versus mini-open rotator cuff repair: a comprehensive review and meta-analysis. Am J Sports Med 2008; 36; 1824-8.
  31. Seida JC, LeBlanc C, Schouten JR, et al. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med 2010; 153: 246-55. Annals of Internal Medicine  
  32. Karjalainen TV, Jain NB, Page CM, et al. Subacromial decompression surgery for rotator cuff disease. Cochrane Database Syst Rev. 2019 Jan 17;1:CD005619. doi:10.1002/14651858.CD005619.pub3. The Cochrane Library  
  33. Kim YS, Lee HJ, Park I, et al. Are Delayed Operations Effective for Patients With Rotator Cuff Tears and Concomitant Stiffness? An Analysis of Immediate Versus Delayed Surgery on Outcomes. Arthroscopy. 2014 Oct 8.
  34. Houck DA Kraeutler MJ Schuette HB, et al. Early versus delayed motion after rotator cuff repair. Am J Sports Med. 2017 Mar 1:363546517692543 . doi:10.1177/0363546517692543 DOI  
  35. Jenssen KK, Lundgreen K, Madsen JE, Kvakestad R, Pripp AH, Dimmen S. No Functional Difference Between Three and Six Weeks of Immobilization After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Non-Inferiority Trial. Arthroscopy. 2018 Oct;34(10):2765-2774. Epub 2018 Sep 6. PMID: 30195953. PubMed  
  36. Storheim K, Gjersing L, Bølstad K, Risberg MA. Sjokkbølge- og trykkbølgebehandling ved kroniske muskel- og skjelettsmerter. Tidsskr Nor Legeforen 2010; 130: 2360-4. Tidsskrift for Den norske legeforening  
  37. Zhao JG, Zhao L, Jiang YX, et al. Platelet-Rich Plasma in Arthroscopic Rotator Cuff Repair: A Meta-Analysis of Randomized Controlled Trials. Arthroscopy. 2014 Sep 30.
  38. Chen X, Jones IA, Park C, et al. The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment. Am J Sports Med. 2017 Dec 1:363546517743746. PMID: 29268037 PubMed  
  39. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995; 77: 10-15. PubMed  
  40. Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults: the effect of age, hand dominance and gender. J Bone Joint Surg Br 1995; 77: 296-8. PubMed  
  41. Zingg PO, Jost B, Sukthankar A, Buhler M, Pfirrmann CW, Gerber C. Clinical and structural outcomes of nonoperative management of massive rotator cuff tears. J Bone Joint Surg Am 2007; 89: 1928-34. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Pål Kristensen, spesialist i allmennmedisin, Ranheim legesenter, Trondheim
  • Stig Fossum, fysioterapeut, spesialkompetanse på muskel- og skjelettsykdommer, Moholt Fysioterapi, Trondheim
  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo