Emerging treatments

Dermal allografts

Augmentation of large to massive rotator cuff repairs with bridging human dermal allografts has been associated with superior functional and structural outcome compared with conventional repair. This may be performed arthroscopically or with a mini-open approach.[74][75][76]​​

Ultrasonophoresis

Ultrasonophoresis (with diclofenac) combined with an exercise programme has been shown to improve range of motion, and decrease pain reported by patients with impingement syndrome, compared with exercise alone or iontophoresis plus exercise.[77]

High-energy extracorporeal shockwave therapy and ultrasound-guided needling

One systematic review found that these therapies are associated with good clinical outcomes, with no long-term complications or severe adverse effects reported.[78]​ However, a subsequent Cochrane review reported very few clinically important benefits of shockwave therapy for patients with rotator cuff disease.[79]

Reverse shoulder arthroplasty with lateralisation of the center of rotation

Reverse shoulder arthroplasty (RSA) is an established surgical option that is used for the treatment of cuff tear arthropathy. Systematic reviews and meta-analyses indicate that newer designed prostheses that offer a lateralised centre of rotation RSA may be the preferred approach.[80][81]

Kinesio taping

An elastic adhesive taping (without an active pharmacological agent) used for the rehabilitation treatment of painful conditions. One systematic review reported uncertain effects compared with sham taping, concluding that evidence for kinesio taping in rotator cuff disease efficacy suggests little or no benefit.[82]​ 

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