Surgery vs Non-Surgical Treatment for Rotator Cuff Tears
(ARC Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores whether surgery or physical therapy is more effective for treating rotator cuff tears. Rotator cuff tears often cause shoulder pain and limit movement, and the trial compares these two treatment options to determine which is more effective. Participants should have shoulder pain and an MRI-confirmed tear of 4cm or less and be medically fit for surgery. This study is important as it could guide treatment decisions for those suffering from rotator cuff tears. As an unphased trial, it offers participants the opportunity to contribute to valuable research that could improve treatment options for future patients.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that surgery for rotator cuff tears usually leads to good long-term results. One study found that surgery reduced the chance of needing additional surgery later by over 25%. Another study demonstrated that surgery resulted in fewer complications and improved shoulder movement compared to some other treatments.
Non-surgical options, such as physical therapy, are also popular. Physical therapy is effective, especially for less severe tears, and serves as a good choice for those wishing to avoid surgery.
Both surgery and physical therapy have their own advantages and disadvantages. Surgery might offer better long-term relief, while physical therapy is less invasive. These factors are important to consider when deciding on the best treatment.12345Why are researchers excited about this trial?
Researchers are excited about the treatments for rotator cuff tears because they offer a direct comparison between surgical and non-surgical approaches. Traditional care often involves surgery followed by physical therapy, which can be invasive and requires a lengthy recovery. The non-operative treatment in this trial focuses solely on physical therapy, which could offer a less invasive alternative with fewer risks and quicker recovery times. This trial aims to clarify which method is more effective for patients, potentially changing how rotator cuff tears are treated in the future.
What evidence suggests that this trial's treatments could be effective for rotator cuff tears?
This trial compares surgical and non-surgical treatments for rotator cuff tears. Research has shown mixed results for treating these tears with either surgery or physical therapy. Participants in the operative arm will undergo surgery, which can repair the tear, but 20-94% of patients may experience a recurrence, leading to ongoing shoulder issues. Participants in the non-operative arm will receive physical therapy, which benefits about 75% of patients with non-injury-related tears, providing lasting relief for many. Both methods generally yield good results, but non-surgical treatments often lead to faster initial improvements. Each approach offers benefits, so treatment choice may depend on personal needs and the specific nature of the tear.26789
Who Is on the Research Team?
Nitin Jain, MD
Principal Investigator
University of Michigan
Are You a Good Fit for This Trial?
This trial is for people aged 40 to under 85 with shoulder pain or limited movement due to a small rotator cuff tear, confirmed by MRI. They must be medically fit for surgery (ASA I-III) and able to consent. It's not for those with other primary diagnoses, severe trauma-caused tears, previous surgeries on the affected side, certain muscle-only tears, or contraindications to MRI.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomly assigned to either operative treatment with surgery and post-operative physical therapy or non-operative treatment with physical therapy
Follow-up
Participants are monitored for pain and function outcomes using SPADI and ASES measures
What Are the Treatments Tested in This Trial?
Interventions
- Non-Operative
- Operative
Trial Overview
The study compares two approaches for treating rotator cuff tears: surgical (operative) and non-surgical (non-operative). The goal is to determine which treatment provides better outcomes in terms of pain relief and improved shoulder function.
How Is the Trial Designed?
2
Treatment groups
Active Control
surgery + post-operative physical therapy
non-operative physical therapy
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Michigan
Lead Sponsor
University of Texas Southwestern Medical Center
Lead Sponsor
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Collaborator
Patient-Centered Outcomes Research Institute
Collaborator
Citations
Effectiveness of physical therapy in treating atraumatic full ...
Nonoperative treatment using this physical therapy protocol is effective for treating atraumatic full-thickness rotator cuff tears in approximately 75% of ...
What happens to patients in the long term when we do not ...
Conclusion. Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. While some may argue ...
3.
sportsmedboston.com
sportsmedboston.com/pdf/comparative-time-to-improvement-in-nonoperative-and-operative-treatment-of-rotator-cuff-tears.pdfcomparative-time-to-improvement-in-nonoperative-and- ...
Conclusions: Patients undergoing nonoperative treatment had significantly better outcomes in the initial follow-up period compared with patients undergoing a ...
Operative vs Nonoperative Treatment for Atraumatic ...
Both nonoperative treatment and surgery are offered to patients with rotator cuff tears, with good outcomes for most patients.
Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical ...
Clinicians may use or recommend extracorporeal shock wave therapy to reduce pain and disability in adults with rotator cuff calcific ...
A Narrative Review of Rotator Cuff Tear Management
While surgical treatments generally provide better functional outcomes and pain relief, non-surgical options like physical therapy and corticosteroid ...
Evidence-based Management of Rotator Cuff Tears (Acute ...
The purpose of this review is to discuss the nonoperative and surgical treatment options that are available for both acute and chronic rotator cuff tears, as ...
Outcomes of initial nonoperative treatment of traumatic full- ...
Rotator cuff repair was performed in 18 patients (45%) following an average of 6 months of nonoperative treatment (range, 3-12 months).
Nonoperative Treatment of Rotator Cuff Tears
Rehabilitation or physical therapy has been shown to be an effective conservative treat- ment of rotator cuff tears with best outcomes seen in partial thickness ...
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