Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients

Lazarides, Alexander L.; Alentorn-Geli, Eduard; Choi, Jin-Young; Stuart, Joseph J.; Lo, Ian K.Y.; Garrigues, Grant E.; Taylor, Dean C.

doi:10.1016/j.jse.2015.05.031

Cited by 86 publications

(58 citation statements)

References 35 publications

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“…Although this difference between the two groups in the mean time to start physiotherapy was not calculated to be statistically significant, failure to start shoulder exercises until almost five months postoperatively (145 days) is a substantial delay. Return to work after arthroscopic RCR depends on the type of work the patient does, in addition to other variables such as age, gender, and in some cases workers' compensation [17][18][19] . In a study including 365 patients, Collin et al 17 reported that approximately 20% of the patients were unable to resume normal activity at six months after arthroscopic RCR.…”

Section: Discussionmentioning

confidence: 99%

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Ateşok

MacDonald

Leiter

et al. 2019

Muscle Ligaments and Tendons J

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Introduction:The purpose of this study was to evaluate the effects of deep shoulder infections after RCR on patient outcomes. Methods: A retrospective chart review was conducted involving all patients with deep shoulder infections after arthroscopic RCR (study group). Another group of patients who were matched with the study group by age, gender and rotator cuff tear size, and did not develop deep shoulder infections after arthroscopic RCR were randomly identified (control group). The two groups were compared in terms of time to start physiotherapy, shoulder function, and delay in return to work. Results: There were 10 patients in each group. The mean time to start physiotherapy after surgery was 145.3 (SD=158.8) days for the study group and 40.0 (SD=13.7) days for the control group (p=.051). The average forward elevation of the operated shoulder was 133 (SD=33.4) degrees for the study group, and 172 (SD=12.0) degrees for the control group (p=0.003). The average time to return to work at preoperative level was 5.6 months for the study group and 3 months for the control group. Conclusion: Deep shoulder infections after RCR significantly impedes time to start physiotherapy, shoulder function, and patients' ability to return to work. Level of evidence: III b [retrospective comparative (case-control) study]. KEY WORDS: rotator cuff tear, arthroscopic cuff repair, post-operative complications, deep shoulder infections, patient outcomes. K. Asetok et al.

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Section: Discussionmentioning

confidence: 99%

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Ateşok

MacDonald

Leiter

et al. 2019

Muscle Ligaments and Tendons J

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“…It was concluded that the results support early arthroscopic rotator cuff repair in young, active patients [54]. While age is considered a major factor in determining traumatic vs overuse, after review of 12 nonprospective case series, Lazarides concluded that RCTs in young patients is a different disease than found in the elderly [59]. Their most common injury was a full thickness tear of the SST.…”

Section: Asymptomatic Ftrcts Increase With Agementioning

confidence: 95%

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2017

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The chronicity of rotator cuff tears and their cause with increasing age has been extensively studied resulting in widely varying prevalence estimates. Focusing on a reported prevalence rate that increases with age to as high as 80% for 70 year olds can result in denial of reimbursement for work-related rotator cuff tears based on the presumed existence of underlying tendon pathology. The age at which inherent degeneration of the rotator cuff becomes a consideration in worker's comp judgments is vague at best. There are instances of acute shoulder trauma that occur in individuals as young as 20 years and even younger in athletes before significant tendon degeneration occurs. Multiple studies report low prevalence rates of asymptomatic rotator cuff tears in individuals less than 50 years. Acute shoulder trauma occurring at work in young workers provides strong evidence that the exposure event underlies any resulting shoulder disorder rather than tendon degeneration and as such is compensable. It can be questioned whether work-related acute shoulder trauma occurring at any age should be attributed to inherent tendon degeneration. IntroductionRotator cuff disease is the most common upper extremity disability [1]. Tendons are connective tissues primarily made up of aligned type I collagen fibrils. The primary cells in tendons are fibroblasts which produce the extra cellular matrix components. As a tendon ages, there is a drop in both cell numbers and cell synthetic activity which could affect mechanical function as tendon structure and composition are altered. These changes likely underlie the increase in tendon injuries with aging [2]. The principal focus of this review is the determination between acute traumatic and chronic degenerative rotator cuff tears (RCTs) which has huge implications for compensation of workrelated injuries. Determining the underlying cause of an RCT is complicated by an increasing incidence of asymptomatic rotator cuff disease with increasing age due to ongoing degeneration of the shoulder tendons. As the age of patient's increases and along with possible RC degeneration, it becomes increasingly difficult to exclusively attribute shoulder injuries to work-related trauma. However, ethically and given the original intent of worker compensation legislation, work-related trauma to the shoulder should be compensable [3].Determining the chronicity of tendon tears remains an issue that is still being pursued. Codman in 1931 stated four prescient hypotheses for RC supraspinatus tendon lesions: (1) trauma, (2) calcification, (3) necrosis or osteoarthritis, or (4) direct result of attrition [4]. Extrinsic and intrinsic factors are recognized to affect rotator cuff tears. Neer identified extrinsic factors based on impingement of the cuff against the coracoacromial arch when the arm is elevated in a forward direction leading to tendonitis and tears [5]. Variable morphology of the acromion includes spurs [6][7][8] and a hook-shaped acromion [9,10] that influence the degree of impingement and li...

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“…Although this difference between the two groups in the mean time to start physiotherapy was not calculated to be statistically significant, failure to start shoulder exercises until almost five months postoperatively (145 days) is a substantial delay. Return to work after arthroscopic RCR depends on the type of work the patient does, in addition to other variables such as age, gender, and in some cases workers' compensation [17][18][19] . In a study including 365 patients, Collin et al 17 reported that approximately 20% of the patients was unable to resume normal activity at six months after arthroscopic RCR.…”

confidence: 99%

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Ateşok

MacDonald

Leiter

et al. 2019

Muscle Ligaments and Tendons J

View full text Add to dashboard Cite

Introduction: The purpose of this study was to evaluate the effects of deep shoulder infections after RCR on patient outcomes. Methods: A retrospective chart review was conducted involving all patients with deep shoulder infections after arthroscopic RCR (study group). Another group of patients who were matched with the study group by age, gender and rotator cuff tear size, and did not develop deep shoulder infections after arthroscopic RCR was randomly identified (control group). The two groups were compared in terms of time to start physiotherapy, shoulder function, and delay in return to work. Results: There were 10 patients in each group. The mean time to start physiotherapy after surgery was 145.3 (SD=158.8) days for the study group and 40.0 (SD=13.7) days for the control group (p=.051). The average forward elevation of the operated shoulder was 133 (SD=33.4) degrees for the study group, and 172 (SD=12.0) degrees for the control group (p=0.003). The average time to return to work at pre-operative level was 5.6 months for the study group and 3 months for the control group. Conclusions: Deep shoulder infections after RCR significantly impedes time to start physiotherapy, shoulder function, and patients' ability to return to work. Level of evidence: Retrospective comparative (case-control) study. Level III b.

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Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients

Cited by 86 publications

References 35 publications

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

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The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

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