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Enthesophyte presence, teardrop distance may predict abductor tendon tears
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When controlling for all variables, recently published results showed enthesophyte presence and teardrop distance were predictive of an abductor tendon tear.
Benjamin G. Domb, MD, and colleagues matched 152 patients with an intraoperative diagnosis of a partial- or full-thickness abductor tear to 125 patients without abductor tendon pathology based on age, gender and BMI. All patients underwent a standardized supine anterior-posterior pelvis radiograph, which researchers evaluated for radiographic risk factors and signs of abductor tendon pathology. Researchers measured femoral version on MRI when images were available.
Results showed patients in the abductor group tended to be older with an average age of 58 years compared with an average age of 54 years among patients in the control group. Overall, 90% and 89% of patients in the abductor and control groups, respectively, were women.
According to results of a bivariate analysis, radiographic risk factors included increased pelvic width, body weight moment arm and abductor moment arm, as well as decreased femoral anteversion and enthesophyte presence.
“We have long sought to understand who develops abductor tears, why they develop them and how we can identify them,” Domb told Healio.com/Orthopedics. “After controlling for all other studied variables, we found that pelvic width was significantly associated with abductor tears. This may be due to the greater force required by the abductor in single-leg stance for a wider pelvis, and it may explain why abductor tears are so much more common in women than men.”
The two variables most predictive of abductor tears were teardrop distance and enthesophyte presence, results of a multivariate regression analysis showed. When these two variables were taken into account, researchers found the likelihood of a tear was not significantly increased or decreased by other variables.
“Such [greater trochanteric] GT enthesophytes were indicative of abductor tears with a 94% positive predictive value,” Domb said. “Furthermore, presence of a GT enthesophyte connoted a 20-fold odds ratio of having an abductor tear. This discovery gives the clinician an easily detectable finding on plain radiographs which may offer a useful screening tool for abductor tears.” – by Casey Tingle
Disclosures: Domb reports that he receives support from Arthrex, Breg, ATI, Pacira, Stryker, Orthomerica, DJO Global, Amplitude and Medacta; and is a board member for the American Hip Institute, the Arthroscopy Association of North America Learning Center Committee and Arthroscopy. Please see the full study for a list of all other authors’ relevant financial disclosures.
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