Partial tears of rotator cuff: How to treat?

André B Graça

The Partial tears of rotator cuff (RPCR) are an injury that often causes shoulder pain and are potentially disabling. The prevalence of this disease is estimated between 13 and 32% through cadaveric studies. This work aims to compile the latest information on the therapeutic approach of this disease, with particular emphasis on the importance of surgery in this kind of injury and its indications. The analysis of the current literature shows that advances in arthroscopy have made possible to visualize and treat lesions that had no indication for surgical treatment.

Surgery should be considered when conservative treatment of RPCR shows no improvement after 12 weeks. There is still controversy regarding the surgical technique that ensures better results but it seems that there is a benefit regardless of the surgical technique used.

The evidence suggests that there is benefit in performing surgery of RPCR with > 50% of the footprint affected when conservative treatment is not effective, with significant improvements in the outcome scales (Constant score, ASES score and VAS). The transtendinous technique may be performed in patients with RPCR with less than half the footprint affected. Some authors believe that this way, the progression of the rupture can prevented by decreasing the load on the intact portion of the tendon.

More homogeneous studies are needed that allow direct comparisons and elaboration of meta-analysis, studies with long follow-up to assess the long-term results.

The evidence suggests that there is benefit in performing surgery o with improvements on ASES score and VAS.

Keywords: Shoulder; Rotator Cuff; Partial tears of rotator cuff; Rotator cuff treatment; Shoulder arthroscopy.

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