MANAGEMENT OF ROTATOR CUFF TEARS

These are only guidelines and are not applicable to every clinical situation.

GROUP ONE

DIAGNOSIS:             Rotator cuff intact

                                    Partial thickness tears.

                                    Cuff tendinosis.

MANAGEMENT:      High success rate.

                                    Physiotherapy.

                                    NSAIDs.

                                    Sub-acromial injections.

                                   Err towards non-operative management.

GROUP TWO

DIAGNOSIS:             Small, medium-sized tears.

                                   Tears in younger patients (<60 yo).

                                   High grade partial tears <60 years

                                    Acute tears:   Any size.

                                                        Distinct injury, <3 months.

MANAGEMENT:      High risk of irreversible damage.

                                    Surgery

                                    Err towards early surgery.

GROUP THREE

DIAGNOSIS:             Large, chronic tears.

                                    Tears in elderly (>70 yo).

                                    MRI—chronic changes within cuff.

MANAGEMENT:       Irreversible damage has already occurred.

                                    Physiotherapy.

                                    NSAIDs.

                                    Sub-acromial injections.

                                   Reverse Shoulder Replacement if ongoing pain

                                    Err towards non-operative management.