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While the high prevalence of symptomatic rotator cuff disease remains constant, management strategies continue to evolve. Any practitioner treating patients with shoulder pain must be aware of the natural history, imaging workup, conservative treatment options, and surgical options for patients with rotator cuff tears. There have been numerous improvements in nonoperative management and new surgical options, which are some of the focus of this issue of Clinics in Sports Medicine. It is often clinically challenging to determine the appropriate time to obtain imaging, what the appropriate imaging modality is, how long and what type of conservative treatment is appropriate, and when surgery is relevant, what surgical option is best for improving symptoms and function. We confront these questions and many others in this issue.
The issue opens with a very thorough review of the natural history of rotator cuff disease and indications for conservative and operative treatment. This segues very nicely into an update on imaging modalities for rotator cuff disease and an updated review of injections and biologics for the conservative treatment of rotator cuff disease. The issue then transitions into the numerous operative options for treatment of full-thickness tears, including those arthroscopic options, augmentation, superior capsular reconstruction, tendon transfers, balloon spacers, revision rotator cuff repairs, and reverse arthroplasty. There is also a separate article detailing the management of rotator cuff tears in athletes. The issue finishes by discussing rehabilitation and return to sport after rotator cuff repair.
I would like to thank the editor and editorial staff of Clinics in Sports Medicine for the invitation to put together a comprehensive update on this area and to sincerely thank all of the authors who contributed their expertise and effort to the development of this issue.