Rotator Cuff Repair – Who Benefits from Surgery?
Surgery to repair a torn rotator cuff has a history of good results. Even patients whose tears do not heal completely are generally happy when the procedure reduces pain and improves outcomes.
But not every patient with a rotator cuff tear should go immediately to surgery. Through her own research, review of the literature, and clinical experience, Leesa Galatz, MD, from Washington University School of Medicine, St. Louis, Missouri, has some basic guidelines for determining which patients are most likely to benefit from surgery to repair a rotator cuff tear – and which patients may be fine with non-operative treatment.
Indications for Surgical Cuff Repair
- Painful tears
- Age less than 60-65 years
- Acute tear in <60 years of age
- No muscle trophic changes
- No degenerative joint changes
Indications for Initial Non-operative Treatment
- Older patients, who have a different healing potential than patients younger than 60-65 years
- Irreversible muscle changes – atrophy, fat accumulation, fibrosis
- Degenerative joints
Indications for Surgery in Older Patients
- Acute tears
- Acute tears associated with sudden loss of elevation
- Failure of non-operative treatment