Functional treatment in rotator cuff tears: is it safe and effective? A retrospective comparison with surgical...

The aim of this study was to compare rehabilitation protocol and operative treatment in a population of patients with a diagnosis of small to medium rotator cuff tears (≤3 cm), the null hypothesis being that there would been no difference in terms of clinical outcomes and patient's satisfaction between the rehabilitation protocol and the surgical treatment.

Patients with small to medium supraspinatus tears were retrospectively enrolled in this study and divided in 2 groups: arthroscopic repair (group A, 20 patients) and reinstated (group B, 18 patients). At a mean follow-up of 18 months, both groups underwent clinical (Constant, QuickDash, VAS), dynamometric and ultrasonographic evaluation.

In both groups a significant clinical improvement was registered compared to baseline. However, surgical treatment yielded better results in Constant (p=0.004), Quick-Dash (p=0.0012), VAS (p=0.048) and strength evaluation (p=0.0014). In group A the re-tear rate was 10%, while in group B only 11% of increased tear size was registered.

At a short term follow-up, the surgical treatment of small to medium supraspinatus tears yielded better clinical outcomes compared to the rehabilitation protocol, with better strength outcomes and 10% re-tear rate. Nevertheless, physiotherapy still offers acceptable results and could be a valuable option in patients not undergoing surgery.

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