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These include impingement cases and elderly patients with rotator cuff tears where we are probably not considering repair of the rotator cuff but in younger more active patients where we may be considering a rotator cuff repair but the patient does not want to or is not able to undergo a repair, Hyaluronans are preferred

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Some families started the therapies sequentially, and once episodes stopped or greatly diminished would elect not to treat with agents not yet attempted