A Narrative Review of Rotator Cuff Tear Management: Surgery Versus Conservative Treatment

Abstract

Rotator cuff tears are a prevalent musculoskeletal issue, particularly among middle-aged and elderly individuals, affecting shoulder stability and arm movement. These tears can arise from acute injuries or chronic wear and tear, leading to conditions ranging from tendinopathy to cuff tear arthropathy. The prevalence increases with age, with a significant portion of older adults affected, many of whom may be asymptomatic. This highlights the necessity for effective management strategies to improve patients' quality of life. The objective of this literature review is to evaluate the evidence on treatment options for rotator cuff injuries, particularly comparing the long-term results of surgical versus non-surgical interventions. While surgical treatments generally provide better functional outcomes and pain relief, nonsurgical options like physical therapy and corticosteroid injections can also be effective, especially for smaller tears. The choice of treatment depends on factors like the size of the tear, patient's age, activity level, and overall health. The review highlights the importance of personalized treatment approaches that consider both clinical and economic factors. Although surgical treatments may incur higher initial costs, they often offer superior long-term benefits, especially for younger patients or those with significant tears.