Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: A multicenter prospective cohort study
Open accessAbstract
Purpose To assess the effectiveness of a specific nonoperative physical therapy program in treating atraumatic full-thickness rotator cuff tears using a multicenter prospective cohort study design.Materials and methods Patients with atraumatic full-thickness rotator cuff tears who consented to enroll provided data via questionnaire on demographics, symptom characteristics, comorbidities, willingness to undergo surgery, and patient-related outcome assessments (Short Form 12 score, American Shoulder and Elbow Surgeons score, Western Ontario Rotator Cuff score, Single Assessment Numeric Evaluation score, and Shoulder Activity Scale). Physicians recorded physical examination and imaging data. Patients began a physical therapy program developed from a systematic review of the literature and returned for evaluation at 6 and 12 weeks. At those visits, patients could choose 1 of 3 courses: (1) cured (no formal follow-up scheduled), (2) improved (continue therapy with scheduled reassessment in 6 weeks), or (3) no better (surgery offered). Patients were contacted by telephone at 1 and 2 years to determine whether they had undergone surgery since their last visit. A Wilcoxon signed rank test with continuity correction was used to compare initial, 6-week, and 12-week outcome scores.Results The cohort consists of 452 patients. Patient-reported outcomes improved significantly at 6 and 12 weeks. Patients elected to undergo surgery less than 25% of the time. Patients who decided to have surgery generally did so between 6 and 12 weeks, and few had surgery between 3 and 24 months.Conclusion Nonoperative treatment using this physical therapy protocol is effective for treating atraumatic full-thickness rotator cuff tears in approximately 75% of patients followed up for 2 years.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence shows that a patient's willingness to undergo surgery is one of the main predictors of future surgery, and individuals ending interventions without surgery intention are unlikely to proceed to surgery.
“Evidence shows that a patient’s willingness to undergo surgery is one of the main predictors of future surgery [87], and individuals ending interventions without surgery intention are unlikely to proceed to surgery [88].”
From Digital Rehabilitation for Elbow Pain Musculoskeletal Conditions: A Prospective Longitudinal Cohort Study (2022) · cites this paper as [88]
The Results (Failure of Nonoperative Treatment—Surgery Rates; page unavailable) say that patients who avoid surgery during the first 12 weeks are unlikely to have it later, through two years. That supports the later-surgery portion of the claim, but the paper does not establish that patients who finish treatment without *intending* surgery are the group unlikely to proceed. It records willingness to undergo surgery but does not report it as a main predictor of future surgery. (LLM, conf=0.84)
Experimental — accuracy not yet measuredExercise therapy produces equivalent outcomes to surgery for people with RCRSP/subacromial impingement syndrome/RC tendinopathy and atraumatic partial and full thickness tears.
“people with RCRPS should derive considerable confidence from the research literature that they should achieve at least comparable results as they would if undergoing surgery for RCRSP (Haahr and Andersen, 2006, Haahr et al. , 2005, Ketola et al. , 2009, Ketola, Lehtinen, 2013), and, atraumatic partial thickness tears (Kukkonen, Joukainen, 2014).”
From Rotator cuff related shoulder pain: Assessment, management and uncertainties (2016) · cites this paper as Kuhn et al. , 2013
The Conclusions report that physical therapy was effective for approximately 75% of patients with atraumatic full-thickness tears at two years. The study did not establish outcomes equivalent to surgery or study partial-thickness tears. Its Discussion cites a separate trial in which 12-month scores were significantly better after surgery. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 40 · Cited by 351
- Authors
- Kuhn, J. E., Dunn, W. R., Sanders, R., An, Q., Baumgarten, K. M., Bishop, J. Y., Brophy, R. H., Carey, J. L., Holloway, B. G., Jones, G. L., Ma, C. B., Marx, R. G., McCarty, E. C., Poddar, S. K., Smith, M. V., Spencer, E. E., Vidal, A. F., Wolf, B. R., & Wright, R. W.
- Corresponding author
- Kuhn, John E.
- ORCID
- Venue
- Journal of Shoulder and Elbow Surgery
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 22
- Issue
- 10
- Pages
- 1371-1379
- ISSN
- 1058-2746 (ISSN-L)
- PMC
- PMC3748251
- OpenAlex
- W2098654980
- Cited by
- 351
- References
- 40
- Citations by year
- 2026: 23 · 2025: 23 · 2024: 37 · 2023: 27 · 2022: 23 · 2021: 24 · 2020: 30 · 2019: 42 · 2018: 32 · 2017: 23 · 2016: 18 · 2015: 27 · 2014: 18 · 2013: 4
- FWCI
- 22.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Shoulder and Elbow Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- NFL Charities
- Pfizer
- Vanderbilt University
- Ohio State University
- Arthrex
- American Orthopaedic Society for Sports Medicine
- Hospital for Special Surgery
- National Institutes of Health (UL1TR000448)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23AR052392, 5K23-AR05392-05)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
- Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Keywords
- full-thickness rotator cuff tear, physiotherapy, conservative treatment, patient-reported outcomes, shoulder function, surgical conversion, rotator cuff repair
- MeSH terms
- Shoulder Injuries, Rotator Cuff Injuries, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Shoulder Joint, Tendon Injuries, Range of Motion, Articular, Treatment Outcome, Physical Therapy Modalities
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
