The Natural History of Asymptomatic Rotator Cuff Tears

Moosmayer, Stefan; Tariq, Rana; Stiris, Morten; Smith, Hans‐Jørgen

doi:10.2106/jbjs.l.00185

Cited by 166 publications

(144 citation statements)

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“…In total, 56 articles were included (41 cross‐sectional, 11 cohort, 4 case–control). Imaging modalities included 25 ultrasound 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 24 MRI 15, 16, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 12 radiographs 27, 30, 49, 53, 55, 62, 65, 66, 67, 68, 69, 70, 3 bone scintigraphy 65, 71, 72, 2 PET 73, 74, and no computed tomography. Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, …”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, 44, 49, 53, 55, 62, 65). Most studies included both sexes; 8 studies did not state the sex ratio involved 35, 38, 41, 59, 62, 65, 71, 74, and 1 included males only 34. The nomenclature for defining imaging pathologies varied between studies, and there was no standardized way of defining pathology (see Supplementary Table 3, available on the Arthritis Care & Research web site at http://onlinelibrary.wiley.com/doi/10.1002/acr.23554/abstract).…”

Section: Resultsmentioning

confidence: 99%

“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

Section: Resultsmentioning

confidence: 99%

“…Six ultrasound studies evaluated the relationship between RC tears and symptoms 39, 40, 41, 42, 43, 44 (Tables 4 and 5). Five studies evaluated the relationship between RC tears and pain persistence or progression 39, 40, 42, 43, 44, 3 with function progression 39, 40, 44, and 4 with symptom progression using composite scores 39, 41, 42, 44.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies evaluated the relationship between RC tears and pain persistence or progression 39, 40, 42, 43, 44, 3 with function progression 39, 40, 44, and 4 with symptom progression using composite scores 39, 41, 42, 44.…”

Section: Resultsmentioning

confidence: 99%

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What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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ObjectiveShoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging‐detected pathologies, symptoms, and their persistence.MethodsA systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross‐sectional and longitudinal relationships between imaging‐detected abnormalities and symptoms were analyzed and associations qualitatively characterized by a best‐evidence synthesis based on study design, covariate adjustment, and the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Modalities included ultrasound, magnetic resonance imaging (MRI), radiographs, positron emission tomography (PET), bone scintigraphy, and computed tomography.ResultsA total of 6,569 abstracts was screened and 56 articles were included. In total, 50 studies did not adjust for covariates and 36 analyzed individual pathologies only. The majority of studies showed conflicting results. There was no significant association between most imaging features and symptoms among high‐quality, cross‐sectional studies. There was low‐quality evidence that enhancement of the joint capsule on MRI and increased uptake on PET were associated with symptoms in adhesive capsulitis. Based on high‐quality longitudinal studies, enlarging rotator cuff tears were associated with an increased incidence of symptoms.ConclusionThere were conflicting results on the association of imaging features with shoulder symptoms and their persistence. The existing evidence was very low in quality, based on the GRADE methodology. Further high‐quality studies are required to understand the relationship between imaging and shoulder symptoms and to determine the appropriate role of imaging in care pathways.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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Surgery for rotator cuff tears

Karjalainen

Jain

Heikkinen

et al. 2019

Cochrane Database of Systematic Reviews

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Strain distribution due to propagation of tears in the anterior supraspinatus tendon

et al. 2014

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Rotator cuff tears are a significant clinical problem. Tears in the anterior supraspinatus might behave differently compared to central tears due to differences in regional structural properties. The objective of this study was to determine strain distributions for anterior supraspinatus tendon tears and the relationship to tear propagation during cyclic loading. It was hypothesized that highest maximum principal strain would be posterior to the tear, and tears would propagate in the direction of the maximum principal strain. Eight human cadaveric supraspinatus tendons with surgically created small tears in the anterior third were tested with increasing levels of cyclic loads. The position of strain markers was recorded on the bursal surface of the tendon to calculate strain. Tendons reached a 2 cm critical tendon retraction at 580 ± 181 N. Largest strains were found medial and posterior to the tear (26.1 ± 9.4%). In five tendons, the strain direction for the initial (114 ± 28°) and final loading sets (86 ± 20°) indicated the strain direction shifted from an anterior to posterior orientation (p < 0.01), corresponding to the direction of tear propagation. Based on the results, anterior supraspinatus tears would remain isolated to the supraspinatus tendon during activities of daily living.

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The Natural History of Asymptomatic Rotator Cuff Tears

Abstract: Background:Little is known about the ciinical and anatomic progression of asymptomatic rotator cuff tears. The purpose of our study was to assess if deterioration in rotator cuff tear anatomy wouid be correiated to the deveiopment of symptoms.

Cited by 166 publications

References 1 publication

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Surgery for rotator cuff tears

Strain distribution due to propagation of tears in the anterior supraspinatus tendon

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