title: Rotator cuff disease: opinion regarding surgical criteria and likely outcome.
abstract: BACKGROUND
  Clinical guidelines for the management of rotator cuff disease are not clear. Surgeon surveys in the USA and UK lack agreement regarding surgical indications. Physical examination tests aid surgical decision-making but also lack robust evidence. Study aims were to evaluate: Western Australian orthopaedic surgeons' perceptions about surgical indications; utility of physical examination tests; findings at surgery predictive of outcome and surgeon opinion of a successful surgical outcome.
  
  
  METHODS
  An anonymous rotator cuff survey, previously reported by the American Academy of Orthopaedic Surgeons, was emailed to all surgeons listed with the Australian Orthopaedic Association in Western Australian. Surgeons who treated patients for rotator cuff disease during the previous 12 months were invited to complete the rotator cuff survey and five additional questions were included to capture the above criteria of interest.
  
  
  RESULTS
  Within a close community of surgeons based in Western Australia (n = 23) considerable heterogeneity exists in surgical decision-making criteria. A successful surgical outcome was considered to include reduced pain levels, restoration of movement and function and gains in muscle strength.
  
  
  CONCLUSIONS
  Research is required to inform robust clinical practice guidelines for rotator cuff surgery. Identification of prognostic factors for successful surgical outcome is imperative.
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Thorpe
authors.affiliation: Department of Orthopaedic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Hurworth
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Sullivan
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Mitchell
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Smith
mesh_terms: D000066491:Clinical Decision-Making; D006801:Humans; D000072161:Orthopedic Surgeons; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D000070636:Rotator Cuff Injuries / Q000175:diagnosis* / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014904:Western Australia
keywords: rotator cuff disease; surgeon opinion; surgical criteria