
What factors will predict someone transitioning from physical therapy to surgery for a symptomatic atraumatic full-thickness rotator cuff tear? The MOON (Multicenter Orthopaedic Outcomes Network) Shoulder group recently published a study where they followed individuals for a 10 year period after diagnosis of symptomatic atraumatic full-thickness rotator cuff tears to identify what factors would predict surgical intervention.
The investigators followed 452 individuals for the study of which 115 (27%) underwent surgery at some point in the 10 year follow up period. They found that low patient expectations for the efficacy of physical therapy was the greatest predictor of early surgery (within 6 months of diagnosis) with 56.5% of the 115 patients electing for surgery in this time period. Workers’ Compensation status and lower reported shoulder activity level were most associated with later surgery.
Physical therapy was successful in treating >70% of individuals with atraumatic full thickness rotator cuff tear. Outcome measures improved with physical therapy care and did not decline during the 10-year follow up period.
Citation:
Kuhn JE, Dunn WR, Sanders R, Baumgarten KM, Bishop JY, Brophy RH, Carey JL, Holloway BG, Jones GL, Ma CB, Marx RG, McCarty EC, Poddar SK, Smith MV, Spencer EE, Vidal AF, Wolf BR, Wright RW. The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort. J Bone Joint Surg Am. 2024 Jul 9. doi: 10.2106/JBJS.23.00978. Epub ahead of print. PMID: 38980920.