Determining the rate of full-thickness progression in partial-thickness rotator cuff tears: a systematic review

Tsuchiya, Saho; Davison, Erin M; Rashid, Mustafa S.; Bois, Aaron J.; LeBlanc, Justin; More, Kristie D.; Lo, Ian K.Y.

doi:10.1016/j.jse.2020.08.022

Cited by 17 publications

(21 citation statements)

References 30 publications

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“…PTRCT is observed in 5% to 30% of patients with shoulder pain and is a common disease with an incidence similar to that of FTRCT. 17,29 However, there are a limited number of studies on the natural history of PTRCT, especially on disease progression. In 1994, Yamanaka and Matsumoto 34 reported that tears progressed in 80% of patients with PTRCT over a mean follow-up period of 1.1 years.…”

Section: Discussionmentioning

confidence: 99%

“…Partial-thickness rotator cuff tear (PTRCT) is as common as full-thickness rotator cuff tear (FTRCT) 29 and is often associated with more pain than FTRCT, leading to functional limitations. 6,16,30 However, compared with FTRCT, the footprint of the supraspinatus muscle is partially preserved in PTRCT; thus, the retraction of the torn tendon is relatively less severe.…”

mentioning

confidence: 99%

“…However, only a limited number of studies have analyzed the tear progression rate, which yielded various progression rates varying from 15% to 80%. 15,17,29,34 Thus, there is no clear consensus on progression rate of PTRCT. In addition, while a number of studies have analyzed the risk factors of tear progression in FTRCT, there is a lack of studies involving PTRCT.…”

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confidence: 99%

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Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level

Jeon

Kim

2022

Orthopaedic Journal of Sports Medicine

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Background: Partial-thickness rotator cuff tears (PTRCTs) often progress to full-thickness rotator cuff tears (FTRCTs). Thus, it is important to analyze the risk factors for tear progression to determine the proper timing of repair. Purpose: To identify the risk factors associated with progression of PTRCT. Study Design: Case-control study; Level of evidence, 3. Methods: Included were 89 patients diagnosed with PTRCT on magnetic resonance imaging (MRI) scans who underwent nonoperative treatment at the authors’ institution between August 2012 and August 2019. Patient characteristics, shoulder stiffness (compared with the contralateral shoulder); work level (classified as high [heavy manual labor], medium [manual labor with less activity], and low [sedentary activity]); and radiological factors including initial tear size, acromion type (flat, curved, hooked, or heel-shaped), and initial tear involvement (as a percentage of the rotator cuff tendon footprint length) were analyzed to assess their association with tear progression, defined as >20% increase in tear involvement. Results: The mean MRI follow-up period was 22.3 ± 17.2 months (median, 16.1 months; range, 6.4-89.5 months), and tear progression was observed in 12 patients (13.5%). In these 12 patients, tear involvement increased by 60% of the rotator cuff footprint, while mediolateral (ML) and anteroposterior (AP) tear sizes progressed by 1.1 and 1.8 mm, respectively. Univariate regression analysis showed that shoulder stiffness ( P = .031), work level ( P = .001), initial tear involvement ( P < .001), ML and AP tear sizes ( P < .001 and P = .005, respectively), and acromion type ( P = .003) were significantly associated with tear progression. Multivariate regression analysis showed that initial tear involvement (odds ratio [OR], 1.053; 95% CI, 1.006-1.102; P = .026) and high work level (OR, 15.831; 95% CI, 1.150-217.856; P = .039) were independent risk factors for tear progression. The cutoff value for initial tear involvement was 47.5% (sensitivity, 81.8%; specificity, 85.7%). Conclusion: Tear progression was observed in 14% of patients with PTRCT in this study. To predict tear progression, evaluating the tear involvement during initial MRI is essential. The risk of tear progression increased with initial tear involvement >47.5% and a heavy work level.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level

Jeon

Kim

2022

Orthopaedic Journal of Sports Medicine

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“…From these studies, we know that an individual's experience of this disease often does not correspond with the pathophysiology ( 12 ). For instance, tendon defects tend to enlarge slowly over time, but symptoms often resolve ( 13 , 14 ). New pain can cause RCT to seem like a new problem when the asymptomatic shoulder has comparable degeneration ( 15 , 16 ), which is consistent with the known tendency for humans to misinterpret new symptoms as representing new pathology ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

What are People That Seek Care for Rotator Cuff Tendinopathy Experiencing in Their Daily Life?

Ulack

Suarez

Brown

et al. 2022

Journal of Patient Experience

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This qualitative study sought to answer three questions: What is it like to live with rotator cuff tendinopathy? What are the barriers and facilitators of a healthy lifestyle with an aging shoulder? And, what are the outcomes that matter most to people seeking care for rotator cuff tendinopathy? Patients diagnosed with rotator cuff tendinopathy participated in group discussions using semi-structured guides that focus on diagnosis, daily experiences living with rotator cuff tendinopathy, goals, concerns, and clinical care experiences. A hybrid of initial inductive coding of themes and subsequent deductive consideration of these themes within the capability, comfort, and calm framework was utilized. Themes associated with rotator cuff tendinopathy were less restful sleep, difficulty with work and life transitions, loss of baseline abilities, and limitation in social roles in the capability realm; physical pain, despair, and loneliness in the comfort realm; and lack of direction or progress and feeling uncared for in the calm realm. Barriers identified included: the sense that rotator cuff tendinopathy is something correctable rather than age-associated and the sense that painful activities will make the tendinopathy worse (common misconceptions); tenuous relationships and limited trust with clinicians; loss of hope; and a sense that care is directionless. What matters most to a person seeking specialty care for shoulder pain are feeling that they are getting effective care and not being dismissed; maintaining meaningful activity and life roles; and replacing despair and frustration with hope and progress. Anticipating these needs may facilitate the design of more effective care models. Level of Evidence: N/A.

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“…It has been previously reported that the incidence of CaT in asymptomatic individuals is 3%, and the incidence in patients with shoulder pain is 7% [ 2 ]. In magnetic resonance imaging (MRI) examinations of symptomatic or asymptomatic shoulder joints, the incidence of RCTs varies between 30 and 50% [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging evaluation of the correlation between calcific tendinitis and rotator cuff injury

Zhang

et al. 2022

BMC Med Imaging

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Background This study aims to evaluate the incidence of calcific tendinitis (CaT) in rotator cuff tears (RCTs) and to assess the correlation between CaT and RCTs with magnetic resonance imaging (MRI). Methods The MRI of 108 patients with rotator cuff CaT admitted to our hospital from January 2019 to January 2021 were retrospectively analyzed. Another retrospective analysis was made of 108 patients with similar age, gender, occupation, and shoulder injury side to those in the first group. The incidence of RCTs and their correlation with CaT were assessed based on an MRI of shoulder joints. Results There was a statistical difference (p < 0.05) in the incidence of RCTs between the CaT group (23.4%) and the control group (37.2%). No significant difference was observed in the size of the RCTs between the two groups (P = 0.422). In the CaT group, 17.4% of patients had complete tears, compared with 26.3% in the control group. There was no significant correlation between the calcification site and RCTs in the CaT group, and only 3.7% of patients suffered calcification and a tear in the exact location of the same tendon (P > 0.05, r = 0.03). Conclusions Compared with patients with shoulder pain without CaT, patients with rotator cuff CaT suffered no increased risk of RCTs on MRI, so CaT and RCTs may have different pathological causes, and there is no significant correlation between the two.

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Determining the rate of full-thickness progression in partial-thickness rotator cuff tears: a systematic review

Cited by 17 publications

References 30 publications

Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level

Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level

What are People That Seek Care for Rotator Cuff Tendinopathy Experiencing in Their Daily Life?

Magnetic resonance imaging evaluation of the correlation between calcific tendinitis and rotator cuff injury

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