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Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears

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Overview (3)

Data Synthesis: 137 studies met eligibility criteria. All trials had high risk for bias. Cohort and uncontrolled studies were of moderate quality. Reported functional outcomes did not differ between open vs. mini-open repair, mini-open vs. arthroscopic repairs, arthroscopic repairs with vs. without acromioplasty, or single-row vs. double-row fixation. Earlier return to work was reported for mini-open repair vs. open repair and for continuous passive motion with physical therapy vs. physical therapy alone. Open repairs showed greater improvement in function when compared with arthroscopic debridement. Complication rates were low across all interventions.

Limitations: Limited evidence, which was often of low quality, precluded conclusions for most comparisons. Language restrictions may have excluded some relevant studies, and selective outcome reporting may have introduced bias.