title: WITHDRAWN: Interventions for tears of the rotator cuff in adults.
abstract: BACKGROUND
  Tears of the rotator cuff tendons, which surround the joints of the shoulder, are one of the most common causes of pain and disability in the upper extremity.
  
  
  OBJECTIVE
  To review the efficacy and safety of common interventions for tears of the rotator cuff in adults.
  
  
  METHODS
  We searched the Cochrane Bone, Joint and Muscle Trauma Group specialised trail register (July 2002), the Cochrane Controlled Trials Register (The Cochrane Library issue 2, 2002), MEDLINE (1966 to December 2001), EMBASE (1974 to December 2001), Biological Abstracts (1980 to December 2001), LILACS (1982 to December 2001), CINAHL (November 1982 to December 2001), Science Citation Index and reference lists of articles. We also contacted authors and handsearched conference proceedings focusing on shoulder conditions.
  
  
  METHODS
  Randomised or quasi-randomised clinical trials involving tears of the rotator cuff were the focus of this review. All trials involving conservative interventions or surgery were included (non-steroidal anti-inflammatory drugs, intra-articular or subacromial glucocorticosteroid injection, oral glucocorticosteroid treatment, physiotherapy, and open or arthroscopic surgery).
  
  
  METHODS
  Two reviewers independently assessed suitability for inclusion, methodological quality and extracted data. Dichotomous data were presented as relative risks (RR) and 95% confidence intervals (CI), using the fixed effects model.
  
  
  RESULTS
  Eight trials involving 455 people were included and 393 patients analysed. Trials were grouped in eight categories of conservative or surgical treatment. The median quality score of all trials combined was 16 out of a possible 24 points, with a range of 12-18. In general, included trials differed on diagnostic criteria for rotator cuff tear, there was no uniformity in reported outcome measures, and data which could be summarised were rarely reported. Only results from two studies comparing open repair to arthroscopic debridement could be pooled. There is weak evidence for the superiority of open repair of rotator cuff tears compared with arthroscopic debridement.
  
  
  CONCLUSIONS
  There is little evidence to support or refute the efficacy of common interventions for tears of rotator cuff in adults. As well as the need for further well designed clinical trials, uniform methods of defining interventions for rotator cuff tears and validated outcome measures are also essential.
authors.affiliation: Orthopaedic Department, Federal University of Sao Paulo, Av. Lineu de Paula Machado, 660, São Paulo, Brazil, SP 05601-000. bennoale@uol.com.br
authors.forename: Benno
authors.initials: B
authors.lastname: Ejnisman
authors.forename: Carlos V
authors.initials: CV
authors.lastname: Andreoli
authors.forename: Bernardo
authors.initials: B
authors.lastname: Soares
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Peccin
authors.forename: Rene J
authors.initials: RJ
authors.lastname: Abdalla
authors.forename: Flávio
authors.initials: F
authors.lastname: Faloppa
authors.forename: Moisés
authors.initials: M
authors.lastname: Cohen
mesh_terms: D000328:Adult; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000628:therapy