Surgical and nonsurgical management of rotator cuff tears

Although rotator cuff tears may be asymptomatic, symptomatic tears have had treatment varying from nonoperative therapy and debridement with subacromial decompression to operative repair. The benchmark for comparison should be nonoperative treatment when deciding to proceed to operative repair. This review will analyze the recent peer-reviewed publications describing results of operative repair, how this regimen differs with nonoperative treatment, and any outcome differences between operative and nonoperative treatment. Operative repair has consistently shown a higher rate of pain relief in patients (85%) and a better return of strength. Nonoperative treatment is expected to produce satisfactory relief of pain in only 50% of patients and no improvement in strength at long-term follow-up.