Age- and Gender-Related Differences in the Morphology of Cuff Tear Arthropathy: A Cross Sectional Analysis

Abstract

Rotator cuff tear arthropathy (CTA) is the most common reason for reverse total shoulder arthroplasty (RSA). There is minimal understanding of the natural progression of osteoarthritis of the shoulder and of the morphologic differences between men and women and between younger and older patients. This trial comprised 309 patients (342 shoulders) who underwent RSA due to CTA in the period between January 2009 and September 2019. The patients were divided into gender and age groups. Preoperative X-rays, computed tomography and magnetic resonance imaging were conducted using various classifications to describe the morphology of the CTA. Of all 342 analyzed shoulders, 209 were right and 133 were left shoulders. A total of 257 female shoulders and 85 male shoulders were assessed. Both mean age and age distribution were significantly different (74.37 years in female and 70.11 years in male patients, p = 0.001; 70.2% female patients in the age group <75.5 years and 80.1% in the age group >75.5 years, p = 0.045). A larger extent of progression of the fatty infiltration was detected both in the female cohort (p = 0.006) and in the older age group (p = 0.001). Additionally, older patients had significantly higher levels of muscle retraction (Patte; p = 0.003), a lower acromiohumeral distance (p = 0.042) and more advanced CTA (Seebauer; p = 0.006).

Keywords: glenohumeral joint; morphology of cuff tear arthritis; osteoarthritis; rotator cuff tear arthropathy; shoulder; shoulder anatomy.

Figure 1

Gender-related differences in acromiohumeral distance. The linear regression model shows a relation between acromiohumeral distance and progressing age (p = 0.001; r = 0.11).