Update of guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopedic Association Part 2: Operative considerations and treatment of various conditions related to subacromial pain syndrome.

(i) Start with exercise-based therapy (with corticosteroid injection) for isolated, symptomatic, non-traumatic supraspinatus tears.

(ii) Avoid biceps tenotomy/tenodesis on a healthy tendon unless at risk during cuff repair.

(iii) Evaluate patient- and tear-specific factors; use MRI for detailed assessment.

(iv) Consider barbotage for calcific tendinosis; repeat once if needed.