The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Musculoskeletal research

Background:

• Rotator cuff tears are a prevalent tendon injury in adults, causing significant morbidity.
• Optimal management strategies for rotator cuff tears remain unclear.

Purpose of the Study:

• To evaluate the overall treatment response for full-thickness rotator cuff tears using interventions from randomized clinical trials.
• To analyze outcomes across various operative and nonoperative approaches.

Main Methods:

• Systematic review and meta-analysis of 57 randomized controlled trials (RCTs).
• Inclusion criteria: patients aged ≥18 years with full-thickness rotator cuff tears.
• Primary outcome: change in Constant shoulder score at 52 weeks; meta-analysis used standardized mean change.

Main Results:

• A sustained improvement in Constant shoulder scores was observed at 3, 6, and 12 months post-intervention.
• Pooled standardized mean change from baseline was 1.42 at 3 months, 2.73 at 6 months, and 3.18 at 12 months.
• Improvement trends were consistent in both nonoperative and operative treatment groups.

Conclusions:

• Full-thickness rotator cuff tears exhibit a consistent improvement pattern in Constant scores with both operative and nonoperative management.
• The natural history of rotator cuff tears involves improvement over time, irrespective of treatment modality.