Factors Associated With Symptomatic Rotator Cuff Tears: The Rotator Cuff Outcomes Workgroup Cohort Study.
Alan Z Grusky, Amos Song, Peter Kim and 6 others
PMID 33443862WHAT IT FOUND
In patients with shoulder pain, symptomatic rotator cuff tears were more likely with older age, dominant shoulder involvement, and higher BMI.
Smoking and reported shoulder use at work were not linked. This does not prove cause.
Key findings
01Among 266 patients with shoulder pain, 163 (61.3%) had a rotator cuff tear and 103 (38.7%) did not.
02In the adjusted model, greater odds of a rotator cuff tear were associated with older age (odds ratio 1.03 per year), dominant shoulder involvement (odds ratio 2.02), and higher BMI (odds ratio 1.06 per kg/m2).
03Smoking and reported shoulder use at work were not associated with the presence of a rotator cuff tear.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Patients were only aged 45 years or older, so the findings do not apply to younger patients. Patients came from sports medicine or shoulder clinics, so the tear rate may be higher than in primary care. All patients had shoulder pain, so the comparison group was not the general population. The tear outcome was only present or absent, not tear size or severity. Ultrasound was not used to assess shoulders. Some variables with low prevalence were excluded from the analysis. Missing data were handled with imputation. The sample size may have been too small to detect associations for smoking and shoulder use at work. The analysis was cross-sectional, so it cannot show that age, dominant shoulder, or BMI cause tears.
Declared interests
The supplied text does not include a conflicts of interest declaration. The article is listed as Research Support, N.I.H., Extramural.
The easy way to misread this
Do not conclude that older age, dominant shoulder involvement, or higher BMI cause rotator cuff tears or that changing them will prevent a tear. This study only found associations in patients who already had shoulder pain, and its control group also had shoulder pain, so it cannot show cause or apply to people without symptoms.