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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Rotator Cuff Tears: Frequency of Tears   



 - Discussion: 
    - rotator cuff anatomy 
    - diff dx of cuff tears (partial rotator cuff tear
    - etilogy of tear 
    - how do RTC tears heal?

    - surgically demonstratable full thickness RTC tears are present in about 1/5 elderly patients;
    - MRI studies have been published which note a much higher prevalence of RTC tear;
    - prevalence of full-thickness tearing of the rotator cuff ranges from 7% to 40% across multiple studies
    - complete supraspinatus tears may occur in up to 20% after age 32 yrs;
            - after age 40 years, approximately 30% of patients will have cuff tears, and after age 60 yrs, there will be cuff tears in upto 80% of patients;
    - Asymptomatic full-thickness tears are present in 13% of the population between age 50-59 and in over 50% of people older than 80 years old;
    - Teefey SA, et al: 100 shoulders in 98 patients with shoulder pain who had undergone preop US and subsequent arthroscopy were identified;
            - arthroscopic dx was a full-thickness rotator cuff tear in 65 shoulders, a partial-thickness tear in 15, rotator cuff tendinitis in 12, frozen shoulder in 4, arthrosis of AC joint in 2, and a superior labral tear and calcific bursitis in one shoulder each;
    - ultrasonography correctly identified all 65 full-thickness rotator cuff tears (a sensitivity of 100 percent);
            - there were seventeen true-negative and three false-positive ultrasonograms (a specificity of 85 percent);
            - overall accuracy was 96 percent;
            - size of the tear on transverse measurement was correctly predicted in 86 percent of the shoulders with a full-thickness tear;
            - ultrasonography detected a tear in ten of fifteen shoulders with a partial-thickness tear that was diagnosed on arthroscopy.
            - 5 of 6 dislocations and seven of eleven ruptures of the biceps tendon were identified correctly



- References

Outcome of Nonoperative Treatment of Symptomatic Rotator Cuff Tears Monitored by Magnetic Resonance Imaging

Ultrasonography of the Rotator Cuff. A Comparison of Ultrasonographic and Arthroscopic Findings in One Hundred Consecutive Cases 

Aging of the rotator cuff

Natural History of Nonoperatively Treated Symptomatic Rotator Cuff Tears in Patients 60 Years Old or Younger




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, January 3, 2013 4:58 pm