Primerjava konzervativnega in kirurškega zdravljenja rupture kit rotatorne manšete - pregled literature : diplomsko delo

Klarić, Zala (author), Palma, Polona (mentor), Brezovar, Tjaž (comentor), Hlebš, Sonja (reviewer)

Uvod: Rupture rotatorne manšete so pogost vzrok za bolečino in funkcionalno omejitev ramenskega sklepa, zlasti pri srednje starih in starejših odraslih. Posledice so zmanjšana mišična jakost, omejen obseg gibanja ter slabša kakovost življenja. Zdravljenje je lahko konzervativno, s poudarkom na fizioterapiji in vadbeni terapiji, ali kirurško, pri čemer optimalna izbira pristopa pogosto ostaja predmet razprav. Klinični izidi so odvisni tudi od velikosti rupture, starosti pacienta in trajanja simptomov. Namen: Namen diplomskega dela je bil primerjati učinkovitost konzervativnega in kirurškega zdravljenja rupture kit rotatorne manšete Metode dela: Iskanje literature je potekalo v podatkovni bazi PubMed z uporabo izbranih ključnih besed. Vključene so bile randomizirane kontrolirane raziskave, objavljene po letu 2010, v katerih primerjajo konzervativno in kirurško zdravljenje rupture rotatorne manšete. Rezultati: V pregled je bilo vključenih pet randomiziranih raziskav s skupno 696 rameni. V vseh raziskavah je prišlo do klinično pomembnega izboljšanja funkcije ramena in zmanjšanja bolečine tako po konzervativnem kot po kirurškem zdravljenju. Pri majhnih do srednje velikih, predvsem degenerativnih rupturah med pristopoma večinoma ni bilo statistično značilnih razlik. Pri pacientih s popolnimi rupturami je kirurško zdravljenje pogosteje prineslo večje izboljšanje bolečine, funkcije in nekaterih kazalnikov kakovosti življenja. Fizioterapija se je izkazala kot ključni del obeh terapevtskih pristopov. Razprava in zaključek: Konzervativno zdravljenje je učinkovita prva izbira, zlasti pri manjših in degenerativnih rupturah ter pri starejših pacientih, medtem ko ima kirurško zdravljenje večjo vlogo pri obsežnejših rupturah ali pri neuspehu konzervativne terapije. Fizioterapija pomembno vpliva na funkcionalne izide ne glede na izbiro zdravljenja. Odločitev o terapevtskem pristopu mora biti individualno prilagojena glede na velikost rupture, klinično sliko, starost in funkcionalne zahteve pacienta. Za natančnejše klinične smernice so potrebne nadaljnje raziskave z večjimi in bolj homogenimi vzorci ter daljšim spremljanjem pacientov.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, rotatorna manšeta, ruptura, konzervativno zdravljenje, kirurško zdravljenje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Z. Klarić]
• Year: 2026
• Number of pages: 35 str., [5] str. pril.
• PID: 20.500.12556/RUL-189146
• UDC: 615.8
• COBISS.SI-ID: 293390851
• Publication date in RUL: 02.10.2026

Secondary language

• Language: English
• Title: Comparison of conservative and surgical treatment of rotator cuff tears - literature review : diploma work

Abstract

Introduction: Rotator cuff tears are a common cause of pain and functional limitation of the shoulder joint, particularly in middle-aged and older adults. The consequences include reduced muscle strength, limited range of motion, and decreased quality of life. Treatment may be conservative, focusing on physiotherapy and exercise therapy, or surgical, and the optimal approach often remains a matter of debate. Clinical outcomes also depend on tear size, patient age, and duration of symptoms. Purpose: The aim of this thesis was to compare the effectiveness of conservative and surgical treatment for rotator cuff tears. Methods: A literature search was conducted in the PubMed database using selected keywords. Randomized controlled trials published after 2010 comparing conservative and surgical treatment of rotator cuff tears were included. Results: Five randomized studies, with a total of 696 shoulders, were included in the review. All studies reported a clinically significant improvement in shoulder function and a reduction in pain following both conservative and surgical treatment. In small to medium-sized, predominantly degenerative tears, no statistically significant differences between the two approaches were generally observed. However, in patients with full-thickness tears, surgical treatment more frequently resulted in greater improvements in pain, function, and certain quality-of-life indicators. Physiotherapy was a key component of both therapeutic approaches. Discussion and conclusion: Conservative treatment is an effective first-line option, particularly for smaller and degenerative tears and for older patients, while surgical treatment is more appropriate for extensive tears or when conservative therapy fails. Physiotherapy significantly influences functional outcomes regardless of the chosen treatment. The decision regarding the therapeutic approach should be individualized according to tear size, clinical presentation, age, and the patient's functional demands. Further research with larger, more homogeneous samples and longer follow-up periods is needed to establish more precise clinical guidelines.

• Keywords: diploma theses, physiotherapy, rotator cuff, tear, conservative treatment, surgical treatment