{"doi":"10.2106/jbjs.23.00978","title":"The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time","abstract":"BACKGROUND: A prospective cohort study was conducted to assess the predictors of failure of nonoperative treatment, defined as the patient undergoing surgery for symptomatic, atraumatic full-thickness rotator cuff tears. We present the 10-year follow-up data of this population to determine if predictors for surgery change over time, and secondarily we report the outcomes of the cohort. METHODS: At the time of enrollment, demographic, symptom, rotator cuff anatomy, and patient-reported outcome data were collected in patients with symptomatic, atraumatic full-thickness rotator cuff tears. Patients underwent a standard physical therapy protocol for 6 to 12 weeks. Patient data were then collected at 1, 2, 5, 7, and 10 years. Failure of nonoperative treatment was defined as the patient electing to undergo surgery. RESULTS: Of the 452 patients in the original cohort, 20 patients (5%) withdrew from the study, 37 (9%) died before 10 years, and 40 (9%) were otherwise lost to follow-up. A total of 115 patients (27.0%) underwent a surgical procedure at some point during the 10-year follow-up period. Of these patients, 56.5% underwent surgery within 6 months of enrollment and 43.5%, between 6 months and 10 years. Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery. Workers' Compensation status and activity level were more important predictors of later surgery. Patient-reported outcome measures all improved following physical therapy. For patients who did not undergo a surgical procedure, patient-reported outcome measures did not decline over the 10-year follow-up period. CONCLUSIONS: Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery, whereas Workers' Compensation status and activity level were predictors of later surgery. Physical therapy was successful in >70% of patients with symptomatic, atraumatic full-thickness rotator cuff tears at 10 years. Outcome measures improved with physical therapy and did not decline over the 10-year follow-up period. LEVEL OF EVIDENCE: Prognostic Level I . See Instructions for Authors for a complete description of levels of evidence.","journal":"Journal of Bone and Joint Surgery","year":2024,"id":425592,"datarank":0.6942420399300757,"base_score":2.995732273553991,"endowment":2.995732273553991,"self_citation_contribution":0.4493598410330987,"citation_network_contribution":0.2448821988969771,"self_endowment_contribution":0.4493598410330987,"citer_contribution":0.2448821988969771,"corpus_percentile":71.19981434207473,"corpus_rank":3724,"citation_count":19,"citer_count":18,"citers_with_citation_signal":7,"citers_with_endowment":7,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5253,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":481241,"name":"Warren R. 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Marx","orcid":"0000-0002-2894-0198","position":10,"is_corresponding":false},{"id":361542,"name":"Eric C. McCarty","orcid":"0000-0002-8948-5862","position":11,"is_corresponding":false},{"id":893266,"name":"Sourav Poddar","orcid":"0009-0003-5251-8434","position":12,"is_corresponding":false},{"id":361544,"name":"Matthew V. Smith","orcid":"0000-0001-7848-738X","position":13,"is_corresponding":false},{"id":893267,"name":"Edwin E. Spencer","orcid":"0000-0001-5590-0696","position":14,"is_corresponding":false},{"id":482115,"name":"Armando F. Vidal","orcid":null,"position":15,"is_corresponding":false},{"id":361530,"name":"Brian R. Wolf","orcid":"0000-0002-2529-8056","position":16,"is_corresponding":false},{"id":361545,"name":"Rick W. Wright","orcid":"0000-0003-4018-7132","position":17,"is_corresponding":false},{"id":361532,"name":"John E. Kuhn","orcid":"0000-0001-6873-3380","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T01:58:32.160975Z","pmid":"38980920","pmcid":"PMC11593976","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}