Results of surgical management of symptomatic shoulders with partial thickness tears of the rotator cuff

Introduction: The optimal management of partial thickness tears of the rotator cuff (PTRCT) is still controversial. Source of data: A literature search, on PubMed, Cochrane and Google Scholar databases, identified 273 relevant abstracts of articles published in peer-reviewed journals. Twenty-three clinical studies reporting the outcomes of surgically treated patients affected by PTRCTs were selected. Areas of agreement: The different repair approaches results in variable functional outcomes. The Coleman Methodology Score (CMS) used to asses the quality of the studies showed great heterogeneity in study design, the sample, pre- and post-operative diagnostic assessments and the score used to evaluate outcomes. The mean CMS value was 67.95 (ranging from 30 to 82). Areas of controversy: The heterogeneity of the treatment options and of the outcome assessment methods makes it difficult to compare the results of the different studies. Growing points: There is a need to use standardized pre- and post-operative assessment methods and functional outcome scores. To improve the diagnosis and to choose the best treatment, it may be useful to measure the thickness of the rotator cuff to ascertain whether the size correlates with outcome. Conclusion: There is a lack of scientifically based guidelines, probably a result of the relatively low levels of evidence of the studies. There is a need for adequately powered randomized clinical trials, using standard diagnostic assessment, common and validated scoring system comparing reported outcomes and duration of follow-up greater than 2 years.