Patients (180 shoulders) above 55 years of age with non-traumatic supraspinatus tears were analyzed one year post-intervention to determine if rotator cuff repair is superior to alternative treatment approaches. Patients were randomly allocated to a physiotherapy group, acromioplasty and physiotherapy group, or rotator cuff repair, acromioplasty and physiotherapy group and evaluated for outcome using the Constant score. Results revealed that rotator cuff repair did not yield superior results compared to acromioplasty and/or physiotherapy. Surgical interventions were associated with significantly greater costs than physiotherapy alone.