This is the question often asked and contestedly debated. There are general reasons why patients require surgery, mostly when a rotator cuff tear is full thickness. Full thickness tears don’t really have any possibility of self repair and tend to get bigger with time. There are direct reasons why the first choice would be surgery, and they include the age of the patient, the thickness of the tear, the general activity of the patient, and failure of conservative measures.
Understanding Rotator Cuff Tear Surgery Options
Often, the question is asked, as to whether or not we should be fixing partial rotator cuff tears. The best shoulder surgeons in Melbourne will often say that they should be reserved for failure of conservative methods.
There would be some exceptions to that rule, such as a very young patient, or mechanical reasons for the tear. For example, if a patient has a hooked acromion or an os acromiale, causing impingement and rotator cuff tearing, the chance of that not requiring surgery in the future is remote. These can often be treated conservatively with physiotherapy and injections, but in all likelihood these would develop into larger tears as time passes.
However, most of the best shoulder surgeons in Melbourne would suggest conservative therapy at the outset for partial thickness rotator cuff tears and only considering surgery when these methods have failed or there’s other pathologies or issues seen in the shoulder.
When we talk about full thickness tears, we’re talking about the depth of the tear rather than the length or the width. But these all come into some consideration, which is why experienced and highly skilled shoulder surgeons should be consulted when the patient is unclear or treating practitioners are unclear about the next best step.