Prognosis

Multiple studies have found that surgical repair provides a good functional result and high level of patient satisfaction.

For patients with low functional demands, nonsurgical rehabilitation may be preferable and, in many cases, can provide a good and durable outcome.

Surgical repair

The primary goal of surgery is to provide a pain-free joint with good function. Arthroscopic, mini-open, and open surgery all have good patient satisfaction with regard to this goal.[36][84][85][86]​​ Patients can anticipate a return to normal function by 26-52 weeks, depending on extent of tear, associated pathology, and activity level.

Failure of tendon healing may not necessarily correlate with poor outcome or reduced patient satisfaction.[87][88]​​​ However, one review suggests important differences in clinical outcome likely exist between patients with healed and nonhealed rotator cuff repairs, especially with respect to strength.[89]

Older physiologic age, chronicity and retraction of the tear, atrophy, and fatty degeneration of the cuff muscle have all been associated with worse outcomes, regardless of the surgical approach. Additionally, younger, high-demand patients may be faced with limited ability to return to sports and less postoperative satisfaction.

Nonoperative rehabilitation

For patients with low functional demands, a well-designed, nonoperative rehabilitation program consisting of stretching and strengthening of both rotator cuff and periscapular muscles can provide pain relief with a functional arc of motion. Researchers have reported a 68% excellent/good result using a home-based rehabilitation program.[50] One study found that results from a home-based therapy program compare favorably to those of a formal occupational therapy program, with two-thirds of patients in each group having significant improvement after a 2-month program.[90]

In patients with rotator cuff tendinopathy, home versus supervised exercises were similarly effective with no significant differences in pain and disability. Supervision of more than the first session of a 6-week exercise regimen failed to result in significant differences in pain and disability.[91][92]

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