Degenerative Rotator Cuff Tear, Repair or Not Repair? A Review of Current Evidence

Ann R Coll Surg Engl. 2020 Apr;102(4):248-255. doi: 10.1308/rcsann.2019.0173. Epub 2020 Jan 3.

Abstract

Introduction: We review the literature and highlight the important factors to consider when counselling patients with non-traumatic rotator cuff tears on which route to take. Factors include the clinical outcomes of surgical and non-surgical routes, tendon healing rates with surgery (radiological outcome) and natural history of the tears if treated non-operatively.

Methods: A PRISMA-compliant search was carried out, including the online databases PubMed and Embase™ from 1960 to the end of June 2018.

Findings: A total of 49 of the 743 (579 PubMed and 164 Embase™) results yielded by the preliminary search were included in the review. There is no doubt that the non-surgical route with an appropriate physiotherapy programme has a role in the management of degenerative rotator cuff tears. This is especially the case in patients with significant risk factors for surgery, those who do not wish to go through a surgical treatment and those with small, partial and irreparable tears. However, rotator cuff repair has a good clinical outcome with significant improvements in pain, range of motion, strength, quality of life and sleep patterns.

Keywords: Degenerative; Impingement; Repair; Rotator cuff tears; Shoulder.

Publication types

  • Review

MeSH terms

  • Arthroscopy / adverse effects*
  • Humans
  • Musculoskeletal Pain / etiology
  • Musculoskeletal Pain / therapy*
  • Patient Selection
  • Physical Therapy Modalities*
  • Quality of Life
  • Range of Motion, Articular
  • Risk Factors
  • Rotator Cuff Injuries / complications
  • Rotator Cuff Injuries / physiopathology
  • Rotator Cuff Injuries / therapy*
  • Rotator Cuff Tear Arthropathy / etiology
  • Rotator Cuff Tear Arthropathy / prevention & control*
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery
  • Treatment Outcome