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- orthopedic procedures
- physical therapy modalities
- patient reported outcome measures
We warmly thank Randelli and coworkers for their interest in our work.1 Our randomised, pragmatic, controlled trial compared surgical and non-surgical treatments for rotator cuff disease (RCD) with or without full-thickness tendon tears after unsuccessful initial rehabilitation.2
Randelli and coworkers commented that the power of our study lies in the fact that potential eligible patients underwent a systematic, adequately performed 3-month rehabilitation, after which only patients who remained symptomatic were randomised; we agree. Symptoms alleviated in 102 of the 417 shoulders with chronic RCD (mean duration of symptoms 9 months before recruitment) during the 3 month, pragmatic nonoperative treatment. This indicates that conservative management should be carried out in all patients with chronic RCD before considering surgical treatment for full-thickness rotator cuff tear.
Randelli and coworkers criticised us for not reporting baseline characteristics of the prespecified subgroups (RCD with and without full-thickness tendon rupture). They also noted that while …
Handling editor Josef S Smolen
Collaborators The Surgery for rotator cuff disease Finland (SURFIN) Investigators: Markus Sormaala; Tero Irmola; Heidi Lehtokangas; Juho Liukkonen; Konsta Pamilo; Tero Ridanpää; Kai Sirniö; Juhana Leppilahti.
Contributors Concept and design: JP, IK, HK, JY. Acquisition analysis or data interpretation: SC, TF, JY, HK, AT, IK, JP. SC and JP had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.Drafting the manuscript: SC, TF, JY, HK, AT, IK, JP. Critical revision of the manuscript for important intellectual content: SC, TF, JY, HK, AT, IK, JP. Statistical analysis: HK, SC, JP. Funding procurement: JP, IK, JL. Supervision: JP, IK, HK.
Funding This work was supported by grants from the Academy of Finland (grant 12321/13 September 2007) 265646/17 April 2013) and National Competitive Research Funding of the University of Eastern Finland. None of the writers has any conflicts of interest relevant to this article.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.