Clinical Efficacy and Imaging Parameter Analysis of Arthroscopic Treatment for Non-Traumatic Rotator Cuff Tears in Middle-Aged and Elderly Patients

Zhou Jianguo; Tao Tianqi; Cao Jianming

Abstract：Objective To compare the clinical efficacy of different treatment modalities for non-traumatic rotator cuff tears in middle-aged and elderly patients.Methods Between June 2019 and June 2023,326 patients[156 males,170 females;age 55～88 years,mean(69.9±15.5)years]with non-traumatic rotator cuff tears were followed up and divided into four groups:Group A(n=81)received basic care only,Group B(n=82)underwent progressive physical therapy,Group C(n=82)underwent acromioplasty plus progressive physical therapy,Group D(n=81)underwent acromioplasty,rotator cuff repair,and progressive physical therapy.Pain and function were assessed pre-and post-treatment using the visual analogue scale(VAS),Constant-Murley score,Dutch simple shoulder test(DSST),shoulder pain and disability index(SPADI),and American shoulder and elbow surgeons(ASES)evaluation form.3D motion trajectories were analyzed with the Vicon MX40 system,and MRI was used to grade rotator cuff fatty infiltration.Results Group D had longer operative time than Group C because of the additional cuff repair(P＜0.05).At 3-year follow-up,Group D showed superior VAS,SPADI,DSST,Constant-Murley,and ASES scores compared with Groups A,B,and C(P＜0.05).Short-term(6-month)outcomes were comparable across all groups;long-term benefits favored Group D(P＜0.05).3-year post-treatment,Group D demonstrated significantly greater 3D motion amplitude,coordination index,and movement fluency(P＜0.05),and the most pronounced improvement in MRI fatty infiltration grade(P＜0.05).Conclusion In middle-aged and elderly patients with non-traumatic rotator cuff tears,arthroscopic surgery combined with physical therapy offers comparable short-term efficacy to conservative treatment but provides superior long-term improvements in functional scores,3D motion coordination,and retardation of fatty infiltration.