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Age, Tear Size, Extent of Retraction, and Fatty Infiltration Associated With a High Chance of a Similar Rotator Cuff Tear in the Contralateral Shoulder Regardless of Symptoms in Patients Undergoing Cuff Repair in the Index Shoulder

Authors
 Tae-Hwan Yoon  ;  Sung-Jae Kim  ;  Yun-Rak Choi  ;  Kyu-Tae Kang  ;  Yong-Min Chun 
Citation
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol.39(7) : 1611-1617, 2023-07 
Journal Title
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
ISSN
 0749-8063 
Issue Date
2023-07
MeSH
Aged ; Arthroscopy / methods ; Humans ; Lacerations* / surgery ; Magnetic Resonance Imaging ; Retrospective Studies ; Rotator Cuff / pathology ; Rotator Cuff / surgery ; Rotator Cuff Injuries* / pathology ; Rotator Cuff Injuries* / surgery ; Rupture / surgery ; Shoulder / surgery
Abstract
Purpose: To investigate the prevalence of a contralateral rotator cuff tear (RCT) in patients with a symptomatic RCT requiring repair and to determine whether findings from magnetic resonance imaging (MRI) of the affected shoulder can predict the presence of a contralateral tear.

Methods: Patients with atraumatic RCTs who had undergone arthroscopic repair between March 2019 and February 2021 were reviewed in this study. MRI of both shoulder joints was performed to evaluate the bilaterality of RCT. Demographic factors and MRI findings of index shoulders were assessed using logistic regression analysis to reveal any correlations with the presence of RCT in the contralateral shoulder.

Results: A total of 428 patients were enrolled in this study. When the affected shoulders had a posterosuperior rotator cuff (PSRC) or subscapularis tear including either an isolated or combined tear, 63.6% and 67.8% had the same tears on the contralateral side, respectively. A contralateral-side tear was found in 74.6% (185/248) of symptomatic cases and 44.8% (65/145) of asymptomatic cases, which represents a significant difference (P < .001). Logistic regression analysis revealed that age ≥67.5 years, tear size ≥17 mm, Goutallier grade ≥1.5, and Patte grade ≥1.5 were found to be indicative of potential contralateral PSRC tears. By contrast, the presence of a subscapularis tear in the affected shoulder was the only significant risk factor in predicting a potential subscapularis tear in the contralateral shoulder.

Conclusions: Among patients with a symptomatic RCT requiring arthroscopic repair, 63.6% with a PSRC tear and 67.8% with a subscapularis tear in the affected shoulder were found to have a similar tear in the contralateral shoulder regardless of symptoms. Age, tear size, extent of retraction, fatty infiltration of PSRC tears, and the presence of subscapularis tears were identified as factors predictive of tears on the contralateral side.

Level of evidence: Level IV, case series.

Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Full Text
https://www.sciencedirect.com/science/article/pii/S0749806323001743
DOI
10.1016/j.arthro.2023.02.008
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Yoon, Tae Hwan(윤태환) ORCID logo https://orcid.org/0000-0002-2859-5240
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
Choi, Yun Rak(최윤락)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196578
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