PARTIAL ROTATOR CUFF TEAR

Jeong (Jeong, 2023) performed a high quality prospective randomized controlled trials (RCT) comparing debridement versus repair of Yoo and Rhea type 2B (partial ¼ to 1/3 of the footprint) subscapularis tears in 65 patients. The authors noted no difference in clinical outcomes, pain scores, or range of motion, however for the repair group showed significantly better SSC muscle strength compared with the debridement group at 5-year follow-up.

In another high-quality study, Wang (Wang, 2021) and colleagues compared the effects of debridement versus repair of Ellman grade 2 (25-50%) bursal-sided partial-thickness rotator cuff tears. In the author’s publication on 85 patients at short term follow up of 18 months, there was no difference between the two groups in clinical outcomes, pain scores, or MRI findings in terms of muscle atrophy or fat infiltration between the two groups.

Risks and Harms of Implementing this Recommendation
While, given the level of evidence, overtreatment or undertreatment of partial-thickness rotator cuff tears may occur, the available data suggests that only minimal or no harm would be associated with implementing this recommendation.

Future Research
High strength comparative studies between debridement and partial tear repair may further clarify the utility of these two techniques in managing partial rotator cuff tears. Further data characterizing the utility of repair of different partial-thickness tear sizes may also be of benefit.