Surgery or Nonsurgical Management for Degenerative Rotator Cuff Tears?

Patients with rotator cuff tears and subacute or chronic shoulder pain often are referred for surgery if they don't respond to conservative treatment. In clinical trials, nonsurgical and surgical management generally have yielded similar outcomes for patients with partial-thickness tears. But for those with full-thickness tears, a few trials have shown better outcomes with surgery.

This latest trial included patients who presented with at least 3 months of subacromial shoulder pain (mean, 1 year) and rotator cuff tears not attributable to high-energy trauma. All patients initially underwent a 3-month course of physical therapy, and 187 patients (mean age, 56) without satisfactory improvement were randomized to continued conservative manageme…