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Greater risk of tear enlargement observed with full-thickness rotator cuff tears
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Patients with a full-thickness shoulder tears had a greater risk for tear enlargement and progression of muscle degeneration, and a greater risk of pain development was associated with tear enlargement across all tear types, according to study results.
Researchers followed 224 patients with an asymptomatic rotator cuff tear in one shoulder and pain due to rotator cuff disease in the contralateral shoulder for a median of 5.1 years. Overall, 118 patients presented with initial full-thickness tears, 56 presented with initial partial-thickness tears and 50 were controls. The researchers calculated validated functional shoulder scores, as well as annual shoulder ultrasonography and clinical evaluations.
Results showed 49% of shoulders had tear enlargement, with a median time to enlargement of 2.8 years. Severity of the final tear type influenced the occurrence of tear-enlargement events, with 61% of full-thickness tears, 44% of partial-thickness tears and 14% of controls experiencing enlargement, according to the researchers. No relationships were observed between sex or patient age with tear enlargement.
Forty-six percent of patients developed new pain, with a greater risk of pain development associated with final tear type and onset of new pain associated with the presence of tear enlargement. New pain development occurred in 28% of controls, 46% of shoulders with partial-thickness tears and 50% of shoulders with full-thickness tears.
Tear enlargement was associated with progressive degenerative changes of the supraspinatus muscle, according to the researchers. Supraspinatus muscle degeneration increased in 4% of the shoulders with a stable tear compared with 30% of the shoulders with tear enlargement.
The researchers also found increase infraspinatus muscle degeneration in 9% of the shoulders with a stable tear vs. 28% of shoulders where the tear had enlarged. – by Casey Tingle
Disclosures: Keener received a grant from the National Institutes of Health. Please see the full study for a list of all other authors’ relevant financial disclosures.
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