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Indications for Repair: Who Really Needs Surgery?
Book chapter

Indications for Repair: Who Really Needs Surgery?

Robert W. Westermann and Brian R. Wolf
Elite Techniques in Shoulder Arthroscopy, pp.181-192
Springer International Publishing
12/30/2015
DOI: 10.1007/978-3-319-25103-5_16

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Abstract

Rotator cuff tears are a common cause of shoulder pain and disability; the prevalence of rotator cuff tears approximates 30–40 % and increases with age. Indications for repair are controversial and non-standardized [Dunn et al. (J Bone Joint Surg Am 87(9):1978–84, 2005); Wolf et al. (Am J Sports Med 35(6):1007–16, 2007); Oh et al. (Clin Orthop Relat Res 455:52–63, 2007)]. In the absence of comprehensive natural history studies, surgical indications must be closely related to failure of nonoperative care. There is evidence to support performing early surgery in patients with acute traumatic rotator cuff tears. Young, active patients who are skeptical about physical therapy may also benefit from early rotator cuff repair. Elderly patients with atraumatic full-thickness tears should undergo a trial of nonoperative management with a structured physical therapy program before surgery is pursued.
Arthroscopy Indications Nonoperative Repair Rotator cuff Shoulder

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