Date of Award

5-2021

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Daryl Sieg

Keywords

Rotator cuff disease; Rotator cuff tear; Management; Surgery; Physical therapy; Injections; Outcomes

Abstract

Rotator cuff tears are acute or chronic tears of one or more of four specific muscles that encompass the glenohumeral joint. These tears can cause pain, decrease range of motion, and affect an individual for many years if not treated appropriately. The purpose of this literature review is to assess the most appropriate means of treatment between surgery, physical therapy, and injection therapies. The literature review was performed using electronic search databases CINAHL, PubMed, Clinical Key, Cochrane Library, Embase, SPORTDiscus and Research Gate. Studies were included if they directly evaluated the efficacy of surgical rotator cuff methods, physical therapy, corticosteroid injections, mesenchymal stem cell injections, or platelet rich plasma injections. Studies were excluded if the sole purpose was to compare different variations of repairs (single row versus double row, etc.). Other non-operative methods of treatment including acupuncture, alternative therapies, or experimental solutions were also not considered. No anecdotal reports or single case studies were included. Studies were narrowed down by currency, only taking literature from 2015 to current date. The review showed that there are specific variables to consider that will aid in which management route will be most effective. Age, tear size, and patient activity level are three factors which influence outcomes. Conservative measures in chronic rotator cuff tear cases are first line, these include physical therapy and corticosteroid injections. If these therapies fail, then surgery is warranted and is an effective treatment for this injury.

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