The rotator cuff is a group of four tendons that surrounds and stabilizes the shoulder joint during normal arm movements. A rotator cuff tear can result from acute trauma, overload, or degenerative changes. Although medical history and clinical examination may indicate rupture, the final diagnosis is made with imaging. Rotator cuff tears can be classified according to the size, number of tendons involved and the thickness of the tear (partial or full thickness). The most common symptoms are pain, decreased strength and decreased active range of motion. On a general basis, surgery is recommended for acute injuries, especially in younger patients with high functional demands. Surgery for rotator cuff tears in one or more tendons is most often done arthroscopically. In elderly, conservative treatment is recommended, especially in cases with isolated tears of the supraspinatus tendon. In degenerative tears, conservative treatment is recommended initially. The professional community in South-Eastern Norway Regional Health Authority has expressed a need to evaluate the use of surgery for rotator cuff tears.
The Norwegian Institute of Public Health has been commissioned by the National System for Managed Introduction of New Health Technologies within the Specialist Health Service in Norway to conduct a health technology assessment (HTA) of surgery for degenerative rotator cuff tears. We will evaluate and summarize the knowledge base for effect and safety and conduct a health economic evaluation of surgery compared to non-surgical treatment. In consultation with the clinical experts, we have decided to delimit this HTA to focus onfull-thickness rotator cuff tears only.
