Radiographic progression of arthritic changes in shoulders with degenerative rotator cuff tears
Section snippets
Methods
The subjects included in the study are part of a larger cohort of patients with asymptomatic rotator cuff tears who presented for evaluation of shoulder pain secondary to rotator cuff disease in the contralateral shoulder.12, 16 Control subjects with ultrasound scans demonstrating a normal rotator cuff in the study shoulder and a painful rotator cuff tear in the contralateral shoulder were also enrolled. Inclusion criteria for study subjects were (1) bilateral shoulder ultrasonography performed
Results
There were 138 patients who met inclusion criteria, with a total of 397 radiographs evaluated. Interobserver agreement was excellent. For SPO scores, weighted κ was 0.68 (95% confidence interval, 0.63-0.72). For Hamada scores, weighted κ was 0.72 (0.67-0.78). For AHI, intraclass correlation coefficient was 0.88 (0.86-0.90). Of the included patients, 24% were control patients, 28% had partial-thickness tears at baseline, and 49% had full-thickness tears at baseline. Final radiographic follow-up
Discussion
No prior studies have described the natural history of RCTA or the tear-related risk factors for progression of RCTA. Identification of tear-related risk factors is critical for prevention and prognosis and may play a role in surgical indications. The purpose of this study was to determine the rate of progression of RCTA in a cohort of subjects with an asymptomatic rotator cuff tear and to analyze factors associated with arthropathy progression. Although our cohort mostly included patients with
Conclusion
Glenohumeral arthritic changes progress significantly but remain minimal within an 8-year period in early to moderate degenerative cuff disease. Whereas the presence of a rotator cuff tear influences progression in Hamada grade, the magnitude of radiographic progression is not influenced by tear severity or enlargement at midterm time points.
Disclaimer
This work was supported by a grant from the National Institutes of Health (R01 AR051026).
Jay D. Keener is a paid consultant for Arthrex, serves on the editorial board for the Journal of Shoulder and Elbow Surgery, receives research support from the National Institutes of Health and Zimmer, and receives royalties from Genesis.
Aaron M. Chamberlain receives research support from Zimmer-Biomet and is a paid consultant for Arthrex.
Ken Yamaguchi receives royalties from Tornier and Zimmer.
The other
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The work for this manuscript was performed at Washington University Medical Center, St. Louis, MO, USA.
This study was approved by our Institutional Review Board under protocol No. 201103230.