Rotator cuff: epidemiology, natural history, risk and prognostic factors. Current concepts
DOI:
https://doi.org/10.1016/j.rccot.2016.09.001Keywords:
Rotator cuff, Prevalence, Risk Factors, Prognostic Factor, Natural History, Clinical CourseAbstract
The prevalence of rotator cuff pathology depends on whether the study was conducted on cadavers or on a defined patient population. Likewise, injuries may be partial or complete in one or more components of the rotator cuff. However, some patients remain asymptomatic and others symptomatic. Age is an important risk factor in the pathophysiology of rotator cuff injury, but there are intrinsic and extrinsic factors that contribute to the cause of the injury.
There are prognostic factors for good or poor outcomes in the management of rotator cuff pathology that should be taken into account in the clinical course of this condition: age, lifestyle, characteristics of the injury, chronicity, diabetes, and range of motion prior to surgical or medical management.
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Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NC, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev. 2013 Sep;24:CD009020.
Cowan JB, Bedi A, Carpenter JE, Robbins CB, Gagnier JJ, Miller BS. Evaluation of American Academy of Orthopaedic Surgeons Appropriate Us Criteria for the management of full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2016;25:1100-6.
Katzer A, Wening JV, Becker-Männich HU, Lorke DE, Jungbluth KH. Rotator cuff rupture. Vascular supply and collagen fiber processes as pathogenetic factors. Unfallchirurgie. 1997;23:52-9.
Neer CS. Impingement lesions. Clin Orthop. 1983;173:70-7.
Yamanaka K, Fukada H. Pathologic studies of the supraspinatus tendon with reference to incomplete partial thickness tear. En: Takagishi N, editor. The Shoulder. Tokyo: Professional Postgraduate Services; 1987. p. 220-4.
Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77:10-5.
Matsen FA, Titelman RM, Lippitt SB. Rotator cuff. En: Rockwood CA, Matsen FA, Wirth MA, et al., editores. The Shoulder. Philadelphia: WB Saunders; 2004. p. 795-878.
Bedi A, Dines J, Warren RF, Dines DM. Massive tears ofthe rotator cuff. J Bone Joint Surg Am. 2010;92:1894-908.
Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86A:219-24.
Fletcher RH, Fletcher SW, Wagner EH. Epidemiologia clínica, aspectos fundamentales. 2a edición Barcelona: Masson; 2002. p. 115-40.
Ainsworth R, Lewis JS. Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. Br J Sports Med. 2007;41:200-10.
Hsu JE, Horneff JG, Gee AO. Immobilization after rotator cuff repair: What evidence do we have now? Orthop Clin North Am. 2016;47:169-77.
Mosley LH, Finseth F. Cigarette smoking: impairment of digital blood flow and wound healing in the hand. Hand. 1977;9:97-101.
Mallon WJ, Misamore G, Snead DS, Denton P. The impact of preoperative smoking habits on the results of rotator cuff repair. J Shoulder Elbow Surg. 2004;13:129-32.
Beason DP, Abboud JA, Kuntz AF, Bassora R, Soslowsky LJ. Cumulative effects of hypercholesterolemia on tendon biomechanics in a mouse model. J Orthop Res. 2011;29:380-3.
Abboud JA, Kim JS. The effect of hypercholesterolemia on rotator cuff disease. Clin Orthop Relat Res. 2010;468:1493-7.
Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54:41-50.
Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:216.
Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983;173:70-7.
Ogawa K, Yoshida A, Inokuchi W, Naniwa T. Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Shoulder Elbow Surg. 2005;14:591-8.
Chansky HA, Iannotti JP. The vascularity of the rotator cuff. Clin Sports Med. 1991;10:807-22.
Rothman RH, Parke WW. The vascular anatomy of the rotator cuff. Clin Orthop Relat Res. 1965;41:176-86.
Sambandam SN, Khanna V, Gul A, Mounasamy V. Rotator cuff tears: An evidence based approach. World J Orthop. 2015;6:902-18.
Karthikeyan S, Griffin DR, Parsons N, Lawrence TM, Modi CS, Drew SJ, Smith CD. Microvascular blood flow in normal and pathologic rotator cuffs. J Shoulder Elbow Surg. 2015;24:1954-60.
Schiefer M, Mendoc ̧a R, Magnanini MM, Fontenelle C, Pires Carvalho AC, Almeida M, et al. Intraobserver and interobserver agreement of Goutallier classification applied to magnetic resonance images. J Shoulder Elbow Surg. 2015;24:1314-21.
Fletcher RH, Fletcher SW, Wagner EH. Epidemiología clínica, aspectos fundamentales. 2a edición Barcelona: Masson; 2002. p. 115-40.
Goldberg BA, Nowinski RJ, Matsen FA 3rd. Outcome of non-operative management of full-thickness rotator cuff tears. Clin Orthop Relat Res. 382:99-107.
Moosmayer S, Tariq R, Stiris M, Smith HJ. The natural history of symptomatic rotator cuff tears: a three-year follow-up of fifty cases. J Bone Joint Surg Am. 95:1249-55.
Neer CS 2nd, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg Am. 1982;64:319-37.
Hirose K, Kondo S, Choi HR, Mishima S, Iwata H, Ishiguro N. Spontaneous healing process of a supraspinatus tendon tear in rabbits. Arch Orthop Trauma Surg. 2004;124:374-7.
Carpenter JE, Thomopoulos S, Flanagan CL, DeBano CM, Soslowsky LJ. Rotator cuff defect healing: a biomechanical and histologic analysis in an animal model. J Shoulder Elbow Surg. 1998;7:599-605.
Gimbel JA, Mehta S, Van Kleunen JP, Williams GR, Soslowsky LJ. The tension required at repair to reappose the supraspinatus tendon to bone rapidly increases after injury. Clin Orthop. 2004;426:258-65.
Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl. 2006;88:116---21.
Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199---203.
Mall NA, Kim HM, Keener JD, Steger-May K, Teefey SA, Middleton WD, et al. Symptomatic progression of asymptomatic rotator cuff tears: a prospective study of clinical and sonographic variables. J Bone Joint Surg Am. 2010;92:2623-33.
Carbone S, Gumina S, Arceri V, Campagna V, Fagnani C, Postacchini F. The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes. J Shoulder Elbow Surg. 2012;21:56-60.
Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS. Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop Relat Res. 1993;294:103---10.
Hawkins RH, Dunlop R. Nonoperative treatment of rotator cuff tears. Clin Orthop Relat Res. 1995;321:178---88.
Maman E, Harris C, White L, Tomlinson G, Shashank M, Boynton E. Outcome of nonoperative treatment of symptomatic rotator cuff tears monitored by magnetic resonance imaging. J Bone Joint Surg Am. 2009;91:1898---906.
Safran O, Schroeder J, Bloom R, Weil Y, Milgrom C. Natural history of nonoperatively treated symptomatic rotator cuff tears in patients 60 years old or younger. Am J Sports Med. 2011;39:710-4.
Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br. 1995;77:296-8.
Fukuda H. Partial-thickness rotator cuff tears: a modern view on Codman’s classic. J Shoulder Elbow Surg. 2000;9:163-8.
Mall NA, Tanaka MJ, Choi LS, Paletta GA. Factors affecting rotator cuff healing. J Bone Joint Surg Am. 2014;96:778---88.
Gerber C, Meyer DC, Frey E, von Rechenberg B, Hoppeler H, Frigg R, et al. Neer Award 2007: Reversion of structural muscle changes caused by chronic rotator cuff tears using continuous musculotendinous traction. An experimental study in sheep. J Shoulder Elbow Surg. 2009;18:163.
Kim HM, Dahiya N, Teefey SA, Keener JD, Galatz LM, Yamaguchi K. Relationship of tear size and location to fatty degeneration of the rotator cuff. J Bone Joint Surg Am. 2010;92:829---39.
Giphart JE, Brunkhorst JP, Horn NH, Shelburne KB, Torry MR, Millett PJ. Effect of plane of arm elevation on glenohumeral kinematics: a normative biplane fluoroscopy study. J Bone Joint Surg Am. 2013;95:238-45.
Oh JH, McGarry MH, Jun BJ, Gupta A, Chung KC, Hwang J, et al. Restoration of shoulder biomechanics according to degree of repair completion in a cadaveric model of massive rotator cuff tear: importance of margin convergence and posterior cuff fixation. Am J Sports Med. 2012;40:2448-53.
Collin P, Matsumura N, Ladermann A, Denard PJ, Walch G. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg. 2014;23:1195-202.
Costouros JG, Porramatikul M, Lie DT, Warner JJ. Reversal of suprascapular neuropathy following arthroscopic repair of massive supraspinatus and infraspinatus rotator cufftears. Arthroscopy. 2007;23:1152-61.
Mallon WJ, Wilson RJ, Basamania CJ. The association of suprascapular neuropathy with massive rotator cuff tears: a preliminary report. J Shoulder Elbow Surg. 2006;15:395-8.
Moursy M, Forstner R, Koller H, Resch H, Tauber M. Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a modified technique to improve tendon transfer integrity. J Bone Joint Surg Am. 2009;91:1924-31.
Su WR, Budoff JE, Luo ZP. The effect of anterosuperior rotator cuff tears on glenohumeral translation. Arthroscopy. 2009;25:282-9.
Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg. 1999;8:296-9.
Carpenter JE, Thomopoulos S, Flanagan CL, DeBano CM, Soslowsky LJ. Rotator cuff defect healing:a biomechanical and histologic analysis in an animal model. J Shoulder Elbow Surg. 1998;7:599-605.
Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy. 1999;15:126-31.
Thomopoulos S, Hattersley G, Rosen V, Mertens M, Galatz L, Williams GR, et al. The localized expression of extracellular matrix components in healing tendon insertion sites: an in situ hybridization study. J Orthop Res. 2002;20:454-63.
Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87:1229-40.
Walch G, Boulahia A, Calderone S, Robinson AH. The ‘‘dropping and ‘‘horn blowers sign’’ in evaluation of rotator cuff tears. J Bone Joint Surg Br. 1998;80:624-8.
Fermont AJ, Wolterbeek N, Wessel RN, Baeyens JP, de Bie RA. Prognostic factors for successful recovery after arthroscopic rotator cuff repair: a systematic literature review. J Orthop Sports Phys Ther. 2014;44:153-63.
Lee S, Lucas RM, Lansdown DA, Nardo L, Lai A, Link TM, et al. Magnetic resonance rotator cuff fat fraction and its relationship with tendon tear severity and subject characteristics. J Shoulder Elbow Surg. 2015;24:1442-51.
Kuzel BR, Grindel S, Papandrea R, Ziegler D. Fatty infiltration and rotator cuff atrophy. J Am Acad Orthop Surg. 2013;21:613-23.
Rudzki JR, Adler RS, Warren RF, Kadrmas WR, Verma N, Pearle AD, et al. Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age and activity-related changes in the intact asymptomatic rotator cuff. J Shoulder Elbow Surg. 2008;17:96S-100S.
Cho NS, Rhee YG. The factors affecting the clinical outcome and integrity of arthroscopically repaired rotator cuff tears of the shoulder. Clin Orthop Surg. 2009;1:96-104.
Chung SW, Park JS, Kim SH, Shin SH, Oh JH. Quality of life after arthroscopic rotator cuff repair: evaluation using SF-36 and an analysis of affecting clinical factors. Am J Sports Med. 2012;40:631-9.
Flurin PH, Landreau P, Gregory T, et al. Cuff integrity after arthroscopic rotator cuff repair: correlation with clinical results in 576 cases. Arthroscopy. 2007;23:340-6.
Warrender WJ, Brown OL, Abboud JA. Outcomes of arthroscopic rotator cuff repairs in obese patients. J Shoulder Elbow Surg. 2011;20:961-7.
Manaka T, Ito Y, Matsumoto I, Takaoka K, Nakamura H. Functional recovery period after arthroscopic rotator cuff repair: is it predictable before surgery? Clin Orthop Relat Res. 2011;469:1660-6.
Wessel RN, Rasenberg EIJ, Guldemond NA, Lim TE. Artroscopisch rotator cuffepair nader geanalyseerd: een prospectieve studiebij 70 patiënten met een rotator cufflsie. Ned Tijd-schr Orthop. 2007;4:137-42.
Yamaguchi K, Ball CM, Galatz LM. Arthroscopic rotator cuff repair: transition from mini-open to all-arthroscopic. Clin Orthop Relat Res. 2001;390:83---94.
Gulotta LV, Nho SJ, Dodson CC, Adler RS, Altchek DW, MacGillivray JD. Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II----prognostic factors for clinical and radiographic outcomes. J Shoulder Elbow Surg. 2011;20:941-6.
National. Institute for Health and Clinical Excellence. The Guidelines Manual. London, UK: National Institute for Health and Clinical Excellence; 2009.
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