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Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: a study of patients with arthroscopically verified cuff tears 22 years ago
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Kalmar Cty Hosp, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
2018 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 27, no 3, p. E68-E74Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of contralateral full-thickness cuff tears (FTTs) and cuff tear arthropathy (CTA) is presumed to be higher in patients with long-standing cuff tears than in those with newly diagnosed tears, but data are currently lacking. Methods: Sixty-one patients with 38 partial and 23 full-thickness tears of 1 shoulder at arthroscopy were examined with bilateral radiographs, ultrasound, and the Constant-Murley score at a mean of 22 years (range, 21-25 years) after arthroscopy. Results: The overall rate of full-thickness tears in the contralateral shoulder was 50.8%. In patients with a full-thickness tear and CTA (Hamada grade amp;gt;= 2) in the index shoulder at follow-up, 18 of 20 (90%) had a contralateral full-thickness tear and 4 of 20 (20%) had CTA. In patients with a partial tear in the index shoulder at follow-up, 3 of 22 (13.6%) had a contralateral full-thickness tear and none had CTA. CTA changes were more common in patients with FTT and a previous acromioplasty (P amp;lt; .001). The correlation between shoulders was 0.72 for the number of tendons with FTT (P amp;lt; .001), 0.31 for the Hamada grade (P = .016), and 0.65 for the absolute Constant-Murley score (P amp;lt; .001). The number of tendons with a full-thickness tear at follow-up was a risk factor (odds ratio, 3.28; 95% confidence interval, 1.67-6.44; P amp;lt; .001) for a contralateral full-thickness tear. Patients with a partial or full-thickness tear in the contra-lateral shoulder had pain in 39.2% of cases. Conclusion: Patients with long-standing cuff tears have high rates of contralateral cuff tears. The severity of the condition is strongly correlated between the shoulders. Patients with full-thickness tears and a previous acromioplasty have a significantly higher frequency of CTA than patients with cuff tears who had not undergone a previous acromioplasty. (C) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER , 2018. Vol. 27, no 3, p. E68-E74
Keywords [en]
Shoulder; rotator cuff; contralateral tear; cuff tear arthropathy; long-term follow-up; ultrasonography
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-145733DOI: 10.1016/j.jse.2017.10.007ISI: 000425934900002PubMedID: 29249548OAI: oai:DiVA.org:liu-145733DiVA, id: diva2:1192550
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-03-22

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Ranebo, MatsBjörnsson Hallgren, HannaAdolfsson, Lars
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Orthopaedics in Linköping
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Journal of shoulder and elbow surgery
Surgery

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