Surgery for Small-to-Medium–Sized Full-Thickness Rotator Cuff Tears

Nearly 20 years ago, researchers in Norway began a trial in which 103 patients (mean age, 60) with symptomatic full-thickness rotator cuff tears not exceeding 3 cm were randomized to physical therapy or surgery; duration of symptoms averaged about 12 months at enrollment. During the first 5 years of follow-up, mean scores on a standardized scale for pain and function improved substantially in both groups, but improvement was modestly better with surgery than with physical therapy (J Bone Joint Surg Am 2014; 96:1504).

Now, the researchers report 15-year outcomes for the 83 patients available for long-term follow-up. During that interval, 29% of patients who were randomized to physical therapy had crossed over to surgery (mostly during the fir…