Evaluation of Conservative and Operative Treatments in Active Patients with Acromioclavicular (AC) and Rotator Cuff (RC) Injuries
Abstract
Abstract
Introduction: Shoulder pain and disability, particularly acromioclavicular joint (ACJ) and rotator cuff (RC) injuries, are common in a physically active population. Determining operative or rehabilitative treatment plans involve multiple treatment choices influenced by the injury grade and treatment goals, such as return to sport. This thesis investigates the management of treatment for AC and RC injuries
Method: The first study is a scoping review that uses the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) to synthesize 32 studies involving athletes who have undergone conservative or operative treatment for their Rockwood grade III ACJ injuries by evaluating shoulder function outcomes and return to sport (RTS). The second study is a secondary data analysis from a prospective cohort of 343 patients with RC injuries and examines the differences in shoulder function, using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, based on sex and age within a one year follow up.
Results: Study One indicates a slight preference for conservative treatments for ACJ injuries from patient reported outcomes, with surgical treatment preferred for younger athletes. However, they both had similar function scores and RTS for surgical and conservative treatments. Study Two determined that males and older adults had lower disability scores post-surgery.
Discussion: The studies provide insight into the complexities of patient care, patient goals, and the importance of evidence-based clinical practices. Patient-centric experiences is paramount into understanding how to deliver the best rehabilitation protocol.