SHOULDER ARTHROSCOPY

Q:What does science tell us about the best way to manage rotator cuff tears?

A:I have previously written columns summarizing research on the management of rotator cuff tears. A study in the current issue of the American Journal of Sports Medicine further contributes to the prevailing scientific evidence indicating that patients who undergo surgery for rotator cuff tear have significantly better pain relief and functional outcomes compared with patients who decline surgery. Even in cases where adequate pain relief and shoulder function are realized without surgery this does not indicate that the rotator cuff tear has healed. In fact, extensive study has shown that there is little to no potential for healing of the rotator cuff without surgery. In cases where patients are enjoying satisfactory shoulder function in the face of a documented rotator cuff tear they have in actuality come to a place of less painful coexistence with the tear rather than any degree true healing. What is more, we know that these areas of tearing will increase in size over time so even if there is short term relief with nonoperative care the long term implications of the tear must be considered when devising a treatment strategy. Ultimately, the decision to proceed to rotator cuff surgery is individualized for each patient after careful consideration of all factors by the surgeon and patient but this study adds to the body of literature favoring the surgical repair over nonoperative management for this challenging condition. To learn more about the management of rotator cuff disorders visit ohioshouldercenter.com.