Inflammatory, metabolic factors may be associated with concurrent hand OA, rotator cuff tears
Click Here to Manage Email Alerts
Patients with hand osteoarthritis with higher serum high-sensitive C-reactive protein and low HDL levels may have a higher prevalence of concurrent rotator cuff tears, according to published results.
To estimate the prevalence of and evaluate the factors associated with the prevalence of rotator cuff tears and hand OA, researchers obtained plain radiography of both hands, MRI of both shoulders and serum levels of high-sensitive CRP and HDL among 1,150 participants in the rural area of South Korea between June 2013 and December 2015. Researchers diagnosed hand OA and rotator cuff tears by clinical and radiologic findings.
Overall, 307 participants had hand OA. Of these patients, 62.5% also presented with a rotator cuff tear, according to results. Researchers noted patients with hand OA had a higher prevalence of rotator cuff tears compared to patients without hand OA, and patients with hand OA and a rotator cuff tear tended to be older, have higher high-sensitive CRP and lower HDL levels compared to patients without a rotator cuff tear.
Results showed a significant association between age, serum high-sensitive CRP levels of 0.6 mg/L or greater and low HDL levels with rotator cuff tears in patients with hand OA, according to results of a multiple logistic regression analysis. Researchers found a 2.8-fold higher prevalence of rotator cuff tears among patients younger than 60 years of age with low HDL vs. normal HDL. Patients with hand OA with both elevated high-sensitive CRP and low HDL levels had a 2.6-fold higher prevalence of rotator cuff tears, according to results.
“However, this study is a cross-sectional study, and thus the causal relationship between inflammatory or metabolic factors and [rotator cuff tear] RCT could not be determined,” the authors wrote. “Therefore, [hand OA] HOA patients with RCT may not be able to exercise well and may be accompanied by metabolic problems (such as obesity and dyslipidemia), and low-grade inflammation as a result. A further longitudinal study is need to clarify the causes of RCT in patients with HOA.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
Perspective
Back to Top
Samer S. Hasan, MD, PhD
Young Sun Suh, MD, and colleagues provide food for thought in their provocative study on the association of hand OA, metabolic and inflammatory markers, and rotator cuff tears. Their large study of a rural South Korean population found a substantially higher prevalence of rotator cuff tears in patients with hand OA compared with patients without hand OA. Additionally, the prevalence was 2.6-fold higher in patients with hand OA who also had both elevated C-reactive protein levels and lower HDL levels compared to patients with hand OA who had neither. This strongly suggests a role of both metabolic factors and systemic inflammation in the pathogenesis of rotator cuff tears, which is in keeping with previous study.
However, the authors acknowledge that causation cannot be determined from cross-sectional studies such as this one and further research is cleared warranted. Additionally, because patients with rotator cuff tears were somewhat older and had greater hand OA burden than those without tears, it is likely that cumulative overuse and lifestyle represent additional contributing factors. Finally, the authors studied a very specific population so their findings may not generalize to urban patients or to those living outside of South Korea.
Mercy Health/Cincinnati Sports Medicine and Orthopaedic Center
Read more about
Click Here to Manage Email Alerts