Operative Versus Non-Operative Treatment for Atraumatic Rotator Cuff Tears

This is non-blinded, randomized controlled trial. Patients will be randomly assigned to
either an operative or non-operative course of treatment and will be followed for 12 months
from baseline.

Aim 1: To compare pain and function in patients undergoing operative versus non-operative
treatment of atraumatic rotator cuff tears at 12 months of follow-up

Aim 2: To assess effects of rotator cuff tear size and age on comparative outcomes of
operative versus non-operative treatments for atraumatic rotator cuff tears

Inclusion Criteria:

- Aged =>50 years to <85 years

- Shoulder pain and/or loss of range of active motion, strength or function

- MRI-confirmed partial- or full-thickness supraspinatus and/or infraspinatus tear of
4cm or less in longitudinal dimension

- Medically fit for surgery, defined as Category I-III per American Society of
Anesthesiologists (ASA) Physical Status Classification

- Ability and willingness to provide informed consent

Exclusion Criteria:

- Primary diagnosis is something other than a rotator cuff tear

- History (in last 2 years) of shoulder fracture involving the humeral head on affected
side

- Previous rotator cuff surgery on affected side

- Isolated subscapularis &/or teres minor tear on affected side

- Acute rotator cuff tear caused by a severe trauma

- Shoulder used as a weight-bearing joint

- Contraindication to MRI (claustrophobia, pacemaker, pregnancy, shoulder implant, etc.)

- Glenohumeral osteoarthritis on xrays/MRI

- Grade 4 fatty infiltration of rotator cuff (any tendons)

- Candidate for shoulder arthroplasty at baseline

- Non-English speaking