Surgical vs. non-surgical therapy for partial tears of the rotator cuff: a systematic review and meta-analysis of pooled studies with indirect comparison

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Rotator cuff disease (RCD) constitutes the most common cause of shoulder pain, with partial-thickness rotator cuff tears (PT-RCTs) representing a substantial subset that may progress over time. Although both surgical and non-surgical interventions are employed in clinical practice, a consensus regarding the optimal management of symptomatic PT-RCTs is lacking, and a comprehensive synthesis of available evidence has not yet been conducted. Methods A systematic review was conducted according to PRISMA guidelines using MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov, and WHO ICTRP. Studies on arthroscopic surgical and/or non-surgical treatments for PT-RCTs in patients ≥ 18 years were included. Clinical outcomes (Constant Score (CS), ASES Score, VAS for pain) were extracted. Random-effects meta-analysis and descriptive statistics were used to analyze outcomes and study characteristics. Results Of the 9,894 trials screened, 33 trials with a total of 1,818 patients met the inclusion criteria. Comparing pooled weighted mean outcomes across studies, surgical cohorts demonstrated higher scores than non-surgical cohorts in both the CS (p = 0.0095) and the ASES (p = 0.0060). However, no specific surgical technique proved superior, with neither Reconstruction versus Debridement (CS, p = 0.19; ASES, p = 0.06) nor Tear Completion versus Transtendon Repair (CS, p = 0.13; ASES, p = 0.6

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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