{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:30:00Z","timestamp":1793723400318,"version":"4.6.1"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To establish evidence\u2010based consensus recommendations for the management of partial\u2010thickness posterosuperior rotator cuff tears (PT\u2010PS\u2010RCTs). This second part addresses treatment strategies, rehabilitation, return to sport and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This European Society for Sports Traumatology, Knee Surgery and Arthroscopy\u2013European Shoulder Associates (ESSKA\u2010ESA) Formal Consensus was conducted according to the ESSKA Formal Consensus Methodology. A Steering Group (13 shoulder surgeons) developed 33 questions and statements based on a standardized literature review and assigned recommendation grades (A\u2013D) according to the level of evidence. Statements were evaluated by an independent Rating Group (20 shoulder surgeons) through a three\u2010round consensus process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010one Question\u2013Statement (Q\u2013S) pairs achieved strong agreement, generating 30 individual recommendations (1 Grade A, 6 Grade B, 10 Grade C and 13 Grade D). Grade A evidence identified an increased risk of postoperative stiffness after trans\u2010tendon repair of articular\u2010sided PT\u2010PS\u2010RCTs compared with tear completion. Grade B evidence supported conservative treatment for at least 6 months, platelet\u2010rich plasma injections and management of stiffness before surgery; both trans\u2010tendon\/in\u2010situ repair and tear\u2010completion\u2010and\u2010repair showed similar return\u2010to\u2010sport rates, although tear\u2010completion\u2010and\u2010repair had slightly higher retear rates. The most commonly reported patient\u2010reported outcome measures were the American Shoulder and Elbow Surgeons, Constant\u2013Murley and visual analogue scale scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Management should be individualized according to patient characteristics (activity level, sports participation), symptoms, tear morphology and tissue quality rather than based on a single treatment algorithm. Non\u2010surgical treatment is the preferred initial approach, whereas no surgical technique has demonstrated consistent superiority across all clinical scenarios. These recommendations provide clinicians with a practical framework to guide treatment decisions and standardize the management of PT\u2010PS\u2010RCTs in daily clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, formal consensus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70622","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:49:53Z","timestamp":1790009393000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The 2026 ESSKA\u2010ESA formal consensus on partial\u2010thickness posterosuperior rotator cuff tears (Part 2): Treatment strategies, rehabilitation, return to sport and complications"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-0218","authenticated-orcid":false,"given":"Jean","family":"Kany","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique de l'Union, Ramsay Saint\u2010Jean France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0784-2895","authenticated-orcid":false,"given":"Miguel Ruiz","family":"Iban","sequence":"additional","affiliation":[{"name":"Unidad de Hombro y Codo Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"},{"name":"Departamento de Cirug\u00eda, Facultad de Medicina Universidad de Alcal\u00e1, Ciencias Sanitarias y Medicosociales, Alcal\u00e1 de Henares Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6054-6078","authenticated-orcid":false,"given":"Emilio","family":"Calvo","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Reconstructive Surgery Unit, Department of Orthopaedic Surgery and Traumatology Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2846-6999","authenticated-orcid":false,"given":"Claudio","family":"Rosso","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit ARTHRO Medics Ltd Basel Switzerland"},{"name":"Medical Faculty University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Peach","sequence":"additional","affiliation":[{"name":"Manchester Shoulder and Elbow Unit Manchester University NHS Foundation Trust, Wythenshawe Hospital Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3407-7658","authenticated-orcid":false,"given":"Carlos Maia","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital da Luz Torres de Lisboa Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"M\u00e9tais","sequence":"additional","affiliation":[{"name":"Shoulder Departement Elsan, Hopital priv\u00e9 La Chataigneraie Beaumont France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8762","authenticated-orcid":false,"given":"Maristella Francesca","family":"Saccomanno","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Fondazione Policlinico Universitario A. Gemelli, IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berte","family":"B\u00f8e","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-0938","authenticated-orcid":false,"given":"Emmanouil","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Brilakis Orthopaedics Athens Medical Group Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7402-756X","authenticated-orcid":false,"given":"Kerem","family":"Bilsel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Acibadem Maslak Hospital, International Joint Center (IJC) Acibadem Mehmet Ali Aydinlar University Istanbul Sariyer Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7558-2506","authenticated-orcid":false,"given":"Ladislav","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Shoulder Departement Arbor Mea\u2014Artro Center Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-6945","authenticated-orcid":false,"given":"Antoon Van","family":"Raebroeckx","sequence":"additional","affiliation":[{"name":"Shoulder Training and Research Center Orthokliniek AZ Nikolaas Sint\u2010Niklaas Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-3678","authenticated-orcid":false,"given":"Nuno","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital das For\u00e7as Armadas\u2014Polo do Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Martetschl\u00e4ger","sequence":"additional","affiliation":[{"name":"German Shoulder Center ATOS Clinic Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2013-8926","authenticated-orcid":false,"given":"Philippe","family":"Beaufils","sequence":"additional","affiliation":[{"name":"Shoulder Departement ESSKA Consensus Projects Advisor, ESSKA Office, Centre M\u00e9dical Versailles France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-2241","authenticated-orcid":false,"given":"Felix","family":"Dyrna","sequence":"additional","affiliation":[{"name":"Shoulder Departement Gelenkzentrum Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-023-00664-2"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12390"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.24.00063"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(05)70213-3"},{"key":"e_1_2_15_6_1","unstructured":"Haute Autorit\u00e9 de Sant\u00e9. Development of good practice guidelines. Formal consensus method. Saint\u2010Denis: Haute Autorit\u00e9 de Sant\u00e9; 2015."},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.06.007"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.70587"},{"key":"e_1_2_15_9_1","article-title":"Surgery for rotator cuff tears","volume":"12","author":"Karjalainen TV","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9459-2"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12326"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505280213"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290061501"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-20-01092"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7023.71"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.09.019"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(09)80065-7"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/ar.1999.v15.0150121"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03831-4"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70622","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70622","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:06:34Z","timestamp":1793721994000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":18,"alternative-id":["10.1002\/ksa.70622"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70622","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2026-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70622"}}