Gå direkt till huvudinnehållet

Skada på rotatorkuffen

Senast reviderad:
Sakkunnig:


Definition:
Total eller partiell bristning, ruptur eller svikt i en eller flera av rotatorkuffens senor, förorsakat av trauma eller överbelastning.
Förekomst:
Incidensdata föreligger inte, men tillståndet är inte ovanligt.
Symtom:
En skada på rotatorkuffen ger smärta och svårigheter med att elevera eller rotera armen.
Kliniska fynd:
Atrofi av drabbad muskel, minskad aktiv rörelse, smärtbåge, nedsatt kraft vid isometriskt test.
Diagnostik:
MRT är den föreslagna undersökningsmetoden.
Behandling:
Initialt rehab, eventuellt behövs kirurgi i vissa fall.
  1. May T, Garmel GM. Rotator Cuff Injury. 2020 Jul 2. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 31613444. PubMed  
  2. Keener JD, Hsu JE, Steger-May K, Teefey SA, Chamberlain AM, Yamaguchi K. Patterns of tear progression for asymptomatic degenerative rotator cuff tears. J Shoulder Elbow Surg. 2015;24(12):1845-1851. doi:10.1016/j.jse.2015.08.038 DOI  
  3. Khatri C, Ahmed I, Parsons H et al, Underwood M, Metcalfe AJ. The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis. Am J Sports Med. 2019 Jun;47(7):1734-1743. doi: 10.1177/0363546518780694. Epub 2018 Jul 2. PMID: 29963905. PubMed  
  4. Matsen FA. Rotator-cuff failure. N Engl J Med 2008; 358: 2138-47. PubMed  
  5. Khatri C, Ahmed I, Parsons H et al, The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis. Am J Sports Med. 2019 Jun;47(7):1734-1743. doi: 10.1177/0363546518780694. Epub 2018 Jul 2. PMID: 29963905. PubMed  
  6. O'Kane JW, Toresdahl BG. The evidenced-based shoulder evaluation. Curr Sports Med Rep. 2014 Sep-Oct;13(5):307-13. doi: 10.1249/JSR.0000000000000090. PMID: 25211618. PubMed  
  7. 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  
  8. 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. PMID: 26537160 PubMed  
  9. 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  
  10. Schmidt CC, Jarrett CD, Brown BT. Management of rotator cuff tears. J Hand Surg Am. 2015 Feb;40(2):399-408. doi: 10.1016/j.jhsa.2014.06.122. Epub 2015 Jan 1. PMID: 25557775. PubMed  
  11. 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  
  12. Ryösä A, Laimi K, Äärimaa V, Lehtimäki K, Kukkonen J, Saltychev M. Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disabil Rehabil. 2017 Jul;39(14):1357-1363. doi: 10.1080/09638288.2016.1198431. Epub 2016 Jul 6. PMID: 27385156. PubMed  
  13. 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 Apr;46(4):294-306. doi: 10.2340/16501977-1800. dx.doi.org  
  14. 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  
  15. 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  
  16. Desmeules F, Bodreault J, Roy JS et al. The efficacy of therapeutic ultrasound for rotator cuff tendinopathy: A systematic review and meta-analysis. Phys Ther Sport 2015. pmid:25824429 PubMed  
  17. 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  
  18. 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.
  19. 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  
  20. 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  
  21. 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.org  
  22. 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  
  23. Khatri C, Ahmed I, Parsons H, Smith NA, Lawrence TM, Modi CS, Drew SJ, Bhabra G, Parsons NR, Underwood M, Metcalfe AJ. The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis. Am J Sports Med. 2019 Jun;47(7):1734-1743. doi: 10.1177/0363546518780694. Epub 2018 Jul 2. PMID: 29963905. PubMed  
  • Athena Adeli, legitimerad läkare, Karolinska Institutet

Tidigare sakkunniga

  • Björn Salomonsson, med dr och överläkare, Ortopedkliniken, Danderyds sjukhus