Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review

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#humans #rotator-cuff-injuries #conservative-treatment #quality-of-life #treatment-outcome

Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review

Longo et al., 2023 | Sports Med Arthrosc Rev | Systematic Review

Citation

Longo Umile Giuseppe, Lalli Alberto, ... Maffulli Nicola. Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review. Sports Med Arthrosc Rev. 2023-Sep-01;31(3):80-87. doi:10.1097/JSA.0000000000000372

Abstract

BACKGROUND: Conservative management has emerged as an attractive option for partial thickness rotator cuff tears (PT-RCTs). A single algorithmic treatment strategy for patients with symptomatic PT-RCT has not yet been developed. This systematic review aims to ascertain whether a conservative approach to PT-RCTs yields positive results in terms of clinical outcomes and functional recovery. METHODS: This is a systematic review of the literature on patients with PT-RCTs receiving conservative treatment with physiotherapy, platelet-rich plasma (PRP) injections, collagen injections, hyaluronic acid (HA) injections, or corticosteroids injections coupled with polydeoxyribonucleotide (PDRN). Outcomes such as the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons and Constant-Murley Score evaluations, as well as the Shoulder Pain and Disability Index and Euro Quality of Life-5D questionnaires were reported following a conservative approach. RESULTS: Eleven studies were included. Six articles explored the outcomes of patients with PT-RCT treated with PRP injections. Significant improvements in VAS for pain were observed. Two studies examined collagen injections and reported variations in VAS for pain and Constant-Murley Score. Sodium hyaluronate and HA injections were studied in two other articles, showing notable improvements in American Shoulder and Elbow Surgeons scores. Corticosteroid and PDRN injections also displayed favorable outcomes. In addition, physical therapy protocols demonstrated improvements in VAS for pain and strength, particularly with eccentric rehabilitation. CONCLUSIONS: Conservative management of PT-RCTs, involving physical therapy, PRP injections, collagen injections, corticosteroid injections, HA injections, and PDRN in jections, demonstrates favorable clinical outcomes. In addition, favorable results are observed in terms of decreased tear width and improved strength recovery, at least during a short-term follow-up. Unfortunately, long-term insight into the structural integrity of conservatively treated rotator cuff tendons following a partial injury has not been thoroughly evaluated yet. STUDY DESIGN LEVELS OF EVIDENCE: Level IV-systematic review.

Key Findings

Eleven studies were included. Six articles explored the outcomes of patients with PT-RCT treated with PRP injections. Significant improvements in VAS for pain were observed. Two studies examined collagen injections and reported variations in VAS for pain and Constant-Murley Score. Sodium hyaluronate and HA injections were studied in two other articles, showing notable improvements in American Shoulder and Elbow Surgeons scores. Corticosteroid and PDRN injections also displayed favorable outcomes

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population symptomatic pt
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Rotator Cuff Injuries
  • Conservative Treatment
  • Quality of Life
  • Treatment Outcome
  • Shoulder Pain
  • Adrenal Cortex Hormones
  • Collagen
  • Arthroscopy

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09