Due to population aging, emphasis on prolonged and healthy lives, and advancement in radiologic diagnostics, the interest in the most effective treatment and management of rotator cuff tears has been growing in recent years, leading to the development of various novel or improved treatment methods, including surgeries. However, the clinical evidence for the proper therapeutic indications of rotator cuff tears in middle-aged and elderly patients is inadequate, and objective evidences are still lacking.

Therefore, the main objective of the present study was to compare the effects of conservative versus surgical treatment in patients with rotator cuff tears by: 1) identifying the status of and trends in treatments for patients with rotator cuff tears in Korea; 2) comparing the effects of surgical treatment versus conservative treatment through a systematic review of the literature on the treatment of rotator cuff tears; 3) comparing the effects of arthroscopic rotator cuff repair versus conservative treatment by establishing a retrospective cohort of patients with small and medium complete tears, as well as high-grade partial tears, for which the decision on the treatment method is difficult in the actual clinical setting; and 4) identifying the expert perspectives on the treatment of rotator cuff tears.