Working in Partnership

Musculoskeletal Bulletin
Conservative Versus Surgical Management for Patients
With Rotator Cuff Tears: A Systematic Review and
Meta-Analysis  
Research
Reference:
Informin
Longo, U.G., Ambrogioni, L.R., Candela, V., Berton, A.,
g
Practice
Carnevale, A., Schena, E. and Denaro, V., (2021). Conservative
versus surgical management for patients with rotator
cuff tears: a systematic review and meta-analysis. BMC
Musculoskeletal Disorders, 22(1), 1-10. 

Every year in the United States, 4.5 million medical visits are made
for shoulder diseases, of which 70% is mainly due to rotator cuff (RC)
tears. The management of RC tears is a relevant topic with a wide
prevalence, but the optimal treatment for partial and full-thickness RC
tears is still unclear since both conservative and surgical treatment have
strengths and weaknesses.  
 
This study aimed to compare conservative versus surgical management
for patients with full-thickness RC tears in terms of clinical and structural
outcomes. 

Methods and Results

N = 6 articles: surgical vs conservative management of RC tears.  
Primary outcome measures: Constant-Murley score (CMS) and VAS (Visual Analogue Scale). 
CMS: score used in determining functionality after treatment of a shoulder injury. 
VAS: measures the intensity or frequency of symptoms. 
 
12 month follow up:  
CMS: 77.6 ± 14.4 in the surgery group and 72.8 ± 16.5 in the conservative group (4.42, 95% CI − 5.52 to
14.36; P = 0.38, I2 = 84%). 
VAS:  1.4 ± 1.6 in the surgery group and 2.4 ± 1.9 in the conservative group (− 1.08, 95% CI − 1.58 to
− 0.58; P < 0.001, I2 = 0%) in favour of surgery. 

24 month follow up:  

CMS: 77.9 ± 21.4 in the surgery group and 79.1 ± 22.4 in the conservative group (0.40, 95% CI − 4.55 to
5.35; P = 0.87, I2 = 0%). 
VAS: Unable to perform statistical analysis due to one article only reporting graphical data and numerical
data could not be extracted.  

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Working in Partnership

Musculoskeletal Bulletin
Key Points
At a 2-year follow-up, shoulder function evaluated in terms of CMS was not significantly
different between conservative and surgical management. 

At 1-year follow-up a better VAS pain was observed in favour of patients undergoing

surgical repair. 

Further high-quality level-I randomised controlled trials at longer term follow-up are
needed to evaluate whether surgical and conservative treatment provide comparable
long-term results. 

0800 9890031 | info@purephysiotherapy.co.uk | www.purephysiotherapy.co.uk