Position Paper of the Italian Society of Orthopaedics and Traumatology (SIOT) on the Treatment of Rotator Cuff Tears.

Background: Rotator cuff tears (RCTs) are a common condition, particularly among the aging population, and the choice of treatment depends on various factors. There is extensive literature on their management, but still no consensus given all the evidence. Purpose: To provide guidance on the indications for nonoperative or surgical treatment for RCTs. Study Design: Narrative review. Methods: Research of the literature on this topic was performed and articles were analyzed to draw up guidelines. A rating group of professionals specializing in shoulder pathology reviewed the results and integrated them with their clinical experience. Results: It is widely accepted that nonoperative treatment is typically recommended for degenerative tears. Surgical repair is suggested for traumatic tears, degenerative tears unresponsive to nonoperative treatment, and young and active patients with high functional demands. The choice of surgical technique depends on the surgeon's preference.The Società Italiana di Ortopedia e Traumatologia (Italian Society of Orthopaedics and Traumatology) emphasizes the importance of patient evaluation in determining the most appropriate treatment for RCTs. Conclusion: Nonoperative treatment is the first-line choice of treatment in the case of degenerative tears, while in the remaining cases surgical treatment must be considered from the beginning.