Optimal patient selection is key to the success of conservative treatment for rotator cuff tears. The factors associated with pain and loss of function in patients with rotator cuff tears are unclear. Objective To record and analyze the risk factors for failure of conservative treatment or progression of rotator cuff injury and to provide the basis for conservative treatment and surgical treatment of rotator cuff injury.

In this study, patients with rotator cuff injury were selected for conservative treatment through inclusion and exclusion criteria. The patients' general conditions, imaging, and functional scores were recorded. The risk factors for conservative treatment failure or rotator cuff injury progression were recorded and analyzed by conservative treatment and follow-up.

A total of 120 patients were included in this study. Univariate analysis showed that trauma history, industrial injury and traffic accident history, high BMI, low initial Constant score, and low initial ASES score had positive significance and were risk factors for conservative treatment failure. Medical history length, smoking, and alcohol consumption did not affect the outcome of conservative treatment. Logistic multivariate analysis showed that pain degree, acromial type 3, CSA ≥35°, high grade of fat infiltration, tear length, and tear width were the risk factors for conservative treatment failure. Gender, age, Cofield classification, full-thickness or partial tear, and tear depth did not affect the outcome of conservative treatment.

Many factors may affect the outcome of conservative treatment. Among these factors, history of trauma, history of industrial injury and traffic accident, high BMI, low initial Constant score, low initial ASES score, pain degree, acromial type 3, CSA ≥35°, high grade of fat infiltration, tear length and tear width is considered to lead to poor conservative treatment outcome. These factors should be taken into account when making treatment plans for patients.