Pre-operative corticosteroid injections improve functional outcomes in patients undergoing arthroscopic repair of high-grade partial-thickness rotator cuff tears

Background:The aim of this study was to compare rehabilitation protocol and operative treatment in a population of patients with a diagnosis of small to medium rotator cuff tears (≤3 cm), the null hypothesis being that there would been no difference in terms of clinical outcomes and patient's satisfaction between the rehabilitation protocol and the surgical treatment.Methods: Patients with small to medium supraspinatus tears were retrospectively enrolled in this study and divided in 2 groups: arthroscopic repair (group A, 20 patients) and reinstated (group B, 18 patients).At a mean follow-up of 18 months, both groups underwent clinical (Constant, QuickDash, VAS), dynamometric and ultrasonographic evaluation.Results: In both groups a significant clinical improvement was registered compared to baseline.However, surgical treatment yielded better results in Constant (p=0.004),Quick-Dash (p=0.0012),VAS (p=0.048) and strength evaluation (p=0.0014).In group A the re-tear rate was 10%, while in group B only 11% of increased tear size was registered.Conclusion: At a short term follow-up, the surgical treatment of small to medium supraspinatus tears yielded better clinical outcomes compared to the rehabilitation protocol, with better strength outcomes and 10% re-tear rate.Nevertheless, physiotherapy still offers acceptable results and could be a valuable option in patients not undergoing surgery.Level of evidence: III.