{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:05:16Z","timestamp":1790075116912,"version":"4.0.1"},"reference-count":78,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To establish updated international consensus statements on the diagnosis, nonoperative management, and repair of posterosuperior rotator cuff tears, reflecting new evidence, evolving techniques, and ongoing areas of controversy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A consensus process on the treatment of rotator cuff tears was conducted, with 97 shoulder\/sports surgeons from 15 countries participating. There were 9 specific subtopics: (1) Diagnosis, (2) Nonoperative Management, (3) Repair of Posterosuperior Tears, (4) Subscapularis Repair, (5) Graft\/Patch Augmentation and Superior Capsular Reconstruction, (6) Tendon Transfers, (7) Reverse Total Shoulder Arthroplasty, (8) Revision Surgery, and (9) Rehabilitation, Return to Play, and Follow\u2010up. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was indicated by 100% agreement with a proposed statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 50 consensus statements, 30 achieved strong consensus, 17 achieved consensus, and 3 did not achieve any level of consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Strong consensus was achieved across all diagnostic domains, establishing a standardized approach to history, examination, classification, and imaging. Experts agreed that patient evaluation should emphasize mechanism of injury, tissue quality, and activity level and that rotator cuff tears should be classified by size, tendons involved, thickness, fatty infiltration, and retraction. In nonoperative management, consensus supported an initial trial of rehabilitation and activity modification for most partial or chronic full\u2010thickness tears, whereas nonoperative treatment remains appropriate for older, low\u2010demand, or medically unfit patients with traumatic tears. There was agreement that corticosteroid injections may play a role but that surgery should be delayed several weeks after injection. For posterosuperior cuff repair, the panel agreed that indications include failure of nonoperative management, persistent pain or dysfunction, and traumatic or high\u2010demand tears and that the surgical approach (beach chair or lateral decubitus) and repair construct should be based on surgeon preference and tear pattern. There was consistent agreement on key technical principles including tension\u2010free repair, adequate footprint coverage, and the importance of individualized treatment based on tissue quality and patient goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, expert opinion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70365","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:26:05Z","timestamp":1790072765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rotator Cuff Tears Part I: Diagnosis, Nonoperative Management, and Repair of Posterosuperior Tears\u2014An International Expert Consensus Statement"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-2981","authenticated-orcid":false,"given":"Eoghan T.","family":"Hurley","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey G.","family":"Droz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1058-1796","authenticated-orcid":false,"given":"Samuel G.","family":"Lorentz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-1475","authenticated-orcid":false,"given":"Mark A.","family":"Glover","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant E.","family":"Garrigues","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Millett","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute  Vail Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surena","family":"Namdari","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1397-2402","authenticated-orcid":false,"given":"Luciano","family":"Rossi","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires Institute of Orthopedics and Traumatology, Carlos E. Ottolenghi  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Waterman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery &amp; Rehabilitation Wake Forest University School of Medicine Atrium Health Wake Forest Baptist  Winston\u2010Salem North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannan","family":"Mullett","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery UPMC Sports Surgery Clinic  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan F.","family":"Dickens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."},{"name":"Department of Orthopaedic Surgery Walter Reed National Military Medical Center Uniformed Services University of Health Sciences  Bethesda Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Klifto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University  Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Rotator Cuff Tear International Consensus Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"3622","DOI":"10.1016\/j.arthro.2025.01.048","article-title":"High sensitivity and specificity of magnetic resonance arthrography for labral tears, rotator cuff tears, Hill-Sachs lesions, and Bankart lesions: A systematic review and meta\u2010analysis","volume":"41","author":"Elbadry 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