Prevalence and characteristics of asymptomatic tears of the rotator cuff

Moosmayer, Stefan; Smith, Hans‐Jørgen; Tariq, Rana; Larmo, Arne

doi:10.1302/0301-620x.91b2.21069

Cited by 189 publications

(155 citation statements)

References 33 publications

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“…The mean age of these patients was 66 years. This is consistent with a large previously reported study of full-thickness tears in asymptomatic volunteers over 50 years of age, which showed an overall incidence of 8%, with a strong dependence on age [30].…”

Section: Discussionsupporting

confidence: 93%

Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

Hodgson

O’Connor²,

Hensor³

et al. 2012

The British Journal of Radiology

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Objective: Although shoulder pain is often associated with rotator cuff tears, many tears are asymptomatic and are not the cause of the patient's pain. This may explain the persistence of symptoms in some patients despite technically successful rotator cuff repair. It has been proposed that rotator cuff tears cause pain through subdeltoid/ subacromial bursal inflammation. The aim of this study was to determine whether bursal inflammation seen on MRI is associated with pain in patients with rotator cuff tears of the shoulder. Methods: The shoulders of 255 patients were screened with ultrasound. 33 fullthickness rotator cuff tears (18 with shoulder pain and 15 without pain) were identified and subsequently studied using contrast-enhanced MRI of the shoulder. Enhancement of the subacromial bursa was scored independently by two musculoskeletal radiologists. Logistic regression was used to determine whether bursal enhancement was independently associated with pain. Results: There was a significant association between pain and age, with greater likelihood of pain in younger patients. Bursal enhancement was common in both painful and painless tears. No statistically significant link between pain and bursal enhancement was seen, even after accounting for age. Conclusion: Although enhancement of the subdeltoid/subacromial bursa was common, no evidence was found to support the hypothesis that bursal enhancement is associated with pain in rotator cuff tears. It is therefore unlikely to determine reliably which patients would benefit from rotator cuff repair. Advances in knowledge: Bursal enhancement and thickening does not reliably correlate with symptoms or presence of rotator cuff tear.

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Section: Discussionsupporting

confidence: 93%

Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

Hodgson

O’Connor²,

Hensor³

et al. 2012

The British Journal of Radiology

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“…However, recent studies have found that there are cases of asymptomatic RCTs in which the patient exhibits no shoulder symptoms [1][2][3][4][5][6][7][8][9][10]. It is evident that patients with symptomatic RCTs tend to demonstrate restrictions in activities of daily living (ADL); however, few reports have so far evaluated the possible restrictions of ADL in patients with asymptomatic RCTs.…”

Section: Introductionmentioning

confidence: 99%

The effects of rotator cuff tears, including shoulders without pain, on activities of daily living in the general population

Nakajima

Yamamoto

Kobayashi

et al. 2012

Journal of Orthopaedic Science

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“…In a study conducted by Moosmayer et al [85], these three variables were found to correlate with the presence of symptoms in comparison to an asymptomatic group. The authors compared non-operative to operative treatment for smaller tears of 3 cm in size, and found a progression in tear size and structural deterioration over time, which resulted in the recurrence of symptoms and functional depreciation over time.…”

Section: Risks Of Conservative Treatment In Managing a Rotator Cuff Tearmentioning

confidence: 90%

Complete Rotator Cuff Tear: An Evidence-Based Conservative Management Approach

Abdulwahab¹,

Murrell²,

Jenio³

et al. 2018

Advances in Shoulder Surgery

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Rotator cuff disease accounts for 10% of all shoulder pain and major shoulder disability, with limited information concerning the natural history and treatment approaches for the disorder. Our objective is to assess the available evidence for the efficacy and morbidity of commonly used systemic medications, physiotherapy, and injections alongside evaluating any negative long-term effects. Although there is conflicting literature, there appears to be some consensus on the best indicators for choosing to treat a full-thickness tears (FTT) non-operatively to reduce pain and improve function. The risks associated with these tears include the potential of the progression of the tear, a diminished healing potential due to age or longer symptom duration, muscle atrophy, and fatty infiltration. The indications for surgery following conservative treatment are becoming more defined, and an outline regarding what scenarios warrant a transition from an initial conservative treatment plan has been developed. The developing benefits of using mesenchymal stem cells (MSCs) and other biologics have the potential to be disruptive to current treatment protocols in the approaches to healing rotator cuff tears (RCTs). With improved imaging modalities, diagnostic accuracy, and sensitivity, practitioners of the future will hopefully be able to intervene earlier in the disease pathogenesis cycle.

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Prevalence and characteristics of asymptomatic tears of the rotator cuff

Cited by 189 publications

References 33 publications

Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

The effects of rotator cuff tears, including shoulders without pain, on activities of daily living in the general population

Complete Rotator Cuff Tear: An Evidence-Based Conservative Management Approach

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