Risk factors associated to bilateral rotator cuff tears

Abstract

Introduction: Overuse, micro-traumas, and impingement, isolated or combined, are the more common etiological factors for rotator cuff tears. Metabolic disorders (diabetes, adiposity, hypercholesterolemia), hypertension, cigarette smoking and a genetic predisposition are considered risk factors. However, no study has compared the prevalence of these risk factors in subjects with bilateral and monolateral tears.

Hypothesis: Controlateral tears can be observed in patients with symptomatic monolateral rotator cuff lesions, especially in those with comorbidities.

Material and methods: In patients with symptomatic rotator cuff tear, the controlateral shoulders were evaluated by means of ultrasound imaging. Age, BMI, diabetes, hypercholesterolemia, hypertension, cigarette smoking, work habits were registered. Risk factors in subjects with bilateral tears were compared with those with monolateral lesions.

Results: Of the 180 subjects recruited, 69 had a tear in the controlateral shoulder. Higher age and BMI values, heavy repetitive work and diabetes were significantly prevalent in these patients. At multivariate analysis, these factors were independently related to a higher probability to detect bilateral tears.

Discussion: Metabolic risk factors are more heavily involved in presence of bilateral rotator cuff tears, in comparison to monolateral.

Type of study: Original study.

Level of proof: IV.

Keywords: Body mass index; Diabetes; Overuse; Rotator cuff tear; Ultrasonography.