Swiss Medical Board recommends rotator cuff surgery

On January 31, 2020, the non-statutory HTA body, Swiss Medical Board, published the results of the report in which they compared the surgical and non-surgical treatment of rotator cuff tears.

Rotator cuff tears are among the most common locomotor injuries. Around 20 percent of people experience tears at some stage in their lives. This injury can greatly impact everyday activities and the quality of life of the patient. The injury can be treated both surgically and conservatively.  Conservative treatment may involve physiotherapy, pain medications, or steroid injections. Both approaches are effective.

Because of the frequency of this injury, the Swiss Medical Board decided to compare the efficacy, safety, and costs of the two treatment approaches. The following conclusions were drawn:

• The surgery provides better results in terms of shoulder function and pain reduction. But, the treatments do not differ in terms of shoulder movement and muscle strength. Thus, overall differences are moderate
• A five-years post-surgery model demonstrated that the surgical treatment costs CHF 7,000 more per patient, which equals to CHF 90 million on the annual level
• However, each patient is different; therefore, some patients may experience greater benefits than others, with one of the two treatments
• The Board decided to recommend the surgical treatment for this injury, but the patients should be carefully selected, based on their symptoms, lifestyle, and personal characteristics
• The Board emphasized the need for a registry to document the long-term outcomes of different treatment methods

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