Peter J. Millett, M.D., M.Sc., Jonas Pogorzelski, M.D., M.H.B.A., Erik M. Fritz, M.D., Jonathan A. Godin, M.D., M.B.A., and Andreas B. Imhoff, M.D.


Economic pressure highlights the critical need for appropriate diagnosis and treatment of various shoulder pathologies since under-diagnosis and under-treatment can result in increased costs to society in the form of disability and lost production. On the other hand, aggressive over-treatment can further inflate already burgeoning health-care costs and potentially harm the patient. Therefore, it is crucial to distinguish the indications between operative and nonoperative management, especially in common shoulder pathologies such as rotator cuff tears, anterior shoulder instability, biceps tendinitis, lesions to the acromioclavicular joint, and proximal humeral fractures. As a result, a detailed analysis of individual risk factors for potential failures should be performed and treatment should be based on individualized care with consideration given to each patient’s particular injury pattern, functional demands, and long-term goals.

For the complete study: Nonoperative treatment of five common shoulder injuries A critical analysis