Management of Rotator Cuff Injuries: Surgical Repair vs. Conservative Treatment

Abstract

Rotator cuff injuries are a common cause of shoulder pain and dysfunction, resulting from acute trauma or degenerative changes. These injuries, including partial and full-thickness tears, can significantly impair daily activities and reduce quality of life. Treatment options range from conservative measures, such as physical therapy and NSAIDs, to surgical interventions like arthroscopic repair. The choice of treatment depends on factors such as tear size, patient age, and activity level. This review compares the effectiveness of conservative treatment and surgical repair for rotator cuff injuries, focusing on pain relief, functional recovery, and complication rates.

Conservative treatment is typically the first-line approach for partial-thickness tears or patients with lower physical demands. Physical therapy and nonsteroidal anti-inflammatory drugs are common modalities that can improve symptoms, particularly for smaller tears. Corticosteroid injections are also used to provide short-term relief, although their long-term benefits are less clear. For larger or full-thickness tears, surgery is often necessary due to the risk of progressive degeneration and persistent symptoms. Arthroscopic repair is particularly beneficial for younger or more active patients, offering superior long-term outcomes in terms of strength and function.

Studies indicate that while conservative treatment and surgery may offer similar short-term outcomes for smaller tears, surgery provides better long-term recovery for more extensive injuries. Ultimately, the decision between conservative and surgical treatment should be individualized, considering tear size, patient age, activity level, and overall health. Surgery is recommended for full-thickness tears or when conservative treatment fails to yield sufficient improvement, while conservative management remains effective for many smaller tears.