This multicenter prospective cohort compared how quickly patients with rotator cuff tears improve after surgical repair versus physical therapy. Using propensity score weighting and Kaplan-Meier analysis, it tracked time to reach meaningful improvement in SPADI and ASES scores over roughly 5 years. The goal was to inform patient counseling on recovery timelines.
The core teaching point is a timeline, not a winner. Nonoperative care improves patients faster in the first few months, while surgery delivers larger-magnitude gains later. Use this to frame the counseling conversation. A patient who wants earlier relief and accepts a smaller improvement fits physical therapy. A patient wanting maximal improvement and willing to wait 15 to 25 months fits repair.
The early nonoperative advantage is largely an artifact of postoperative recovery. Surgical patients are still healing at 3 months, so early scores understate the eventual surgical benefit.
Reassure patients that both paths carry over 80% probability of meaningful improvement by 5 years. Remember this was a nonrandomized cohort: surgical patients were younger with larger, more traumatic tears, and propensity weighting only adjusts for measured confounders.
This multicenter prospective cohort compared how quickly patients with rotator cuff tears improve after surgical repair versus physical therapy. Using propensity score weighting and Kaplan-Meier analysis, it tracked time to reach meaningful improvement in SPADI and ASES scores over roughly 5 years. The goal was to inform patient counseling on recovery timelines.
The core teaching point is a timeline, not a winner. Nonoperative care improves patients faster in the first few months, while surgery delivers larger-magnitude gains later. Use this to frame the counseling conversation. A patient who wants earlier relief and accepts a smaller improvement fits physical therapy. A patient wanting maximal improvement and willing to wait 15 to 25 months fits repair.
The early nonoperative advantage is largely an artifact of postoperative recovery. Surgical patients are still healing at 3 months, so early scores understate the eventual surgical benefit.
Reassure patients that both paths carry over 80% probability of meaningful improvement by 5 years. Remember this was a nonrandomized cohort: surgical patients were younger with larger, more traumatic tears, and propensity weighting only adjusts for measured confounders.