Rotator cuff tears are one of the most common causes of shoulder pain in adults in the United States, accounting for 10.7 million outpatient doctor visits in 2013. Specifically, it is estimated that 65-70% of adults with shoulder pain have an underlying rotator cuff disorder. Rotator cuff injuries are common due to their degenerative nature, meaning that they occur slowly over time as a person ages, often without a distinct injury. These kinds of tears are classified as atraumatic.
The two standard treatments for atraumatic rotator cuff tears are non-operative (physical therapy alone) and operative (surgery followed by physical therapy). The percentage of rotator cuff patients treated with surgery rose from 33.8% to 40.4% from 2005 to 2012, showing an increasing tendency to treat with surgery. It is not clear, however, if this trend has resulted in more successful outcomes for patients. The purpose of the ARC Trial is to help answer this question. We are also studying whether size of tear and age influence which treatment works best. This trial is different from previous observational studies because patients are randomly assigned to a treatment group, which will allow us to better measure the differences between these two treatments without any biases. We believe this study will help patients and providers to make better and more informed decisions in the future.