‘Physio’s not going to repair a torn tendon’: patient decision-making related to surgery for rotator cuff related shoulder pain

Review written by Andrew Cuff info

Key Points

  1. The rates of surgery for rotator cuff related shoulder pain (RCRSP) are increasing despite uncertainty around effectiveness and efficacy.
All key points available for members only

BACKGROUND & OBJECTIVE

Shoulder pain is the third most common body site for musculoskeletal (MSK) pain, affecting 1 in 4 of us across our lifespan (1). Rotator cuff related shoulder pain (RCRSP) is considered to be the most common cause of shoulder pain (2). Surgery for RCRSP often consists of two main procedures: either a subacromial decompression, or rotator cuff tendon repair. Decompression surgery has been shown to not outperform placebo surgery for improving pain or function at up to 12-months follow up (3), whilst in those undergoing tendon repair, 40% demonstrate a failed repair without a compromise in function at two years.

Despite this uncertainty around surgical intervention, the rates of surgery are increasing across the world. The objective of this review was to explore the decision-making rationale in people who have undergone surgery for RCRSP.

Shoulder pain is the third most common body site for musculoskeletal pain, affecting 1 in 4 of us across our lifespan.
bulb
The decision to proceed with surgery is often based on an outdated pathoanatomic model of shoulder pain involving the acromion, tears, and prognosis.

METHODS

A qualitative investigation was performed using semi-structured interviews as the data collection method. Each participant had undergone surgery for RCRSP in the last 12-months. The interviews were structured using a topic guide that had been developed by the research team.

to unlock full access to this review and 761 more