B K Moor1, M Röthlisberger2, D A Müller3, M A Zumstein2, S Bouaicha4, M Ehlinger5, C Gerber3. 1. Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland; Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: beat.moor@insel.ch. 2. Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland. 3. Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland. 4. Division of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland. 5. Department of Orthopaedic Surgery and Traumatology, Hautepierre Hospital, University of Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
Abstract
BACKGROUND: The pathogenesis of full-thickness tears of the rotator cuff remains unclear. Apart from age and trauma, distinct scapular morphologies have been found to be associated with rotator cuff disease. The purpose of the present study was to evaluate whether a score formed using these established risk factors was able to predict the presence of a rotator cuff tear reliably. METHODS: We retrospectively assessed a consecutive series of patients with a minimal age of 40 years old, who had true antero-posterior (AP) radiographs of their shoulders, as well as a magnetic resonance (MR) gadolinium-arthrography, between January and December 2011. In all of these patients, the critical shoulder angle (CSA) was determined, and MR images were assessed for the presence of rotator cuff tears. Additionally, the patients' charts were reviewed to obtain details of symptom onset. Based on these factors, the so-called rotator cuff tear (RCT) score was calculated. RESULTS: Patients with full-thickness RCTs were significantly older and had significantly larger CSAs than patients with intact rotator cuffs. Multiple logistic regression, using trauma, age and CSA as independent variables, revealed areas under the curve (AUCs) for trauma of 0.55, for age of 0.65 and for CSA of 0.86. The combination of all three factors was the most powerful predictor, with an AUC of 0.92. CONCLUSION: Age, trauma and the CSA can accurately predict the presence of a posterosuperior RCT. LEVEL OF EVIDENCE: Level IV. Case series with no comparison groups.
BACKGROUND: The pathogenesis of full-thickness tears of the rotator cuff remains unclear. Apart from age and trauma, distinct scapular morphologies have been found to be associated with rotator cuff disease. The purpose of the present study was to evaluate whether a score formed using these established risk factors was able to predict the presence of a rotator cuff tear reliably. METHODS: We retrospectively assessed a consecutive series of patients with a minimal age of 40 years old, who had true antero-posterior (AP) radiographs of their shoulders, as well as a magnetic resonance (MR) gadolinium-arthrography, between January and December 2011. In all of these patients, the critical shoulder angle (CSA) was determined, and MR images were assessed for the presence of rotator cuff tears. Additionally, the patients' charts were reviewed to obtain details of symptom onset. Based on these factors, the so-called rotator cuff tear (RCT) score was calculated. RESULTS:Patients with full-thickness RCTs were significantly older and had significantly larger CSAs than patients with intact rotator cuffs. Multiple logistic regression, using trauma, age and CSA as independent variables, revealed areas under the curve (AUCs) for trauma of 0.55, for age of 0.65 and for CSA of 0.86. The combination of all three factors was the most powerful predictor, with an AUC of 0.92. CONCLUSION: Age, trauma and the CSA can accurately predict the presence of a posterosuperior RCT. LEVEL OF EVIDENCE: Level IV. Case series with no comparison groups.
Authors: Peter N Chalmers; Dane Salazar; Karen Steger-May; Aaron M Chamberlain; Ken Yamaguchi; Jay D Keener Journal: Clin Orthop Relat Res Date: 2017-01-24 Impact factor: 4.176