Article

In this systematic review we assessed effectiveness of non-surgical and
(post)surgical interventions for symptomatic rotator cuff tears (RotCuffTear).
The Cochrane Library, PubMed, Embase, Cinahl, and Pedro were searched for
relevant systematic reviews and randomized controlled trials (RCTs). Two reviewers independently selected relevant studies, extracted data and assessed
the methodological quality. Three Cochrane reviews (7 RCTs) and 14 RCTs were
included (3 non-surgery, 10 surgery, 8 post-surgery). For small or medium
RotCufftears, moderate evidence was found in favour of surgery versus
physiotherapy in mid- and long-term. In surgery, tendon-to-bone fixation with one
metal suture anchor loaded with double sutures (TB) was more effective (moderate
evidence) than a side-to-side repair with permanent sutures (SS) in the mid- and
long-term; limited evidence for effectiveness was found in favour of debridement
versus anchor replacement and suture repair of the type II SLAP tear in the
long-term. Further, no evidence was found in favour of any non-surgical, surgical
or post-surgical intervention. In conclusion, although surgery seems to give
better results compared to non-surgery and TB is more effective than SS in rotator cuff repair (RCR), it remains hard to draw firm evidence-based
conclusions for effectiveness of non-surgical or (post)surgical interventions to
treat RotCuffTears. More research is clearly needed.
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