Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
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.
- Seida JC, Leblanc C, Schouten JR, et al. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med 2010;153:246-55.
- Seida J, Schouten JR, Mousavi SS, et al. Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears, Comparative Effectiveness Review No. 22 (Prepared by University of Alberta Evidence-based Practice Center under Contract No. 290-02-0023). Rockville, MD: Agency for Healthcare Research and Quality; July 2010. AHRQ Publication No. 10-EHC050.
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