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Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to analyse the natural course of symptomatic full-thickness and partial-thickness rotator cuff tears treated non-operatively and to identify risk factors affecting tear enlargement.

Methods

One hundred and twenty-two patients who received non-surgical treatment for a partial- or full-thickness supraspinatus tear were included in this study. All rotator cuff tears were diagnosed with magnetic resonance imaging (MRI), and the same modality was used for follow-up studies. Follow-up MRI was performed after at least a 6-month interval. We evaluated the correlation between tear enlargement and follow-up duration. Eleven risk factors were analysed by both univariate and multivariate analyses to identify factors that affect enlargement of rotator cuff tears. The mean follow-up period was 24.4 ± 19.5 months.

Results

Out of 122 patients, 34 (27.9%) patients had an initial full-thickness tear and 88 (72.1%) patients had a partial-thickness tear. Considering all patients together, tear size increased in 51/122 (41.8%) patients, was unchanged in 65/122 (53.3%) patients, and decreased in 6/122 (4.9%) patients. Tear size increased for 28/34 (82.4%) patients with full-thickness tears and 23/88 (26.1%) patients with partial-thickness tears. From the two groups which were followed over 12 months, a higher rate of enlargement was observed in full-thickness tears than in partial-thickness tears (6–12 months, n.s.; 12–24 months, P = 0.002; over 24 months, P < 0.001). Logistic regression revealed that having a full-thickness tear was the most reliable risk factor for tear progression (P < 0.001).

Conclusions

This study found that 28/34 (82.4%) of symptomatic full-thickness rotator cuff tears and 23/88 (26.1%) of symptomatic partial-thickness tears increased in size over a follow-up period of 6–100 months. Full-thickness tears showed a higher rate of enlargement than partial-thickness tears regardless of the follow-up duration. Univariate and multivariate analyses suggested that full-thickness tear was the most reliable risk factor for tear enlargement. The clinical relevance of these observations is that full-thickness rotator cuff tears treated conservatively should be monitored more carefully for progression than partial-thickness tears.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea

    Yang-Soo Kim, Sung-Eun Kim, Sung-Ho Bae, Hyo-Jin Lee & Chang Kyun Park

  2. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Won-Hee Jee

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  1. Yang-Soo Kim
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Correspondence to Sung-Eun Kim.

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Conflict of interest

Yang-Soo Kim, Sung-Eun Kim, Sung-Ho Bae, Hyo-Jin Lee, Won-Hee Jee, and Chang kyun Park declare that they have no conflict of interest.

Funding

This study has no funding.

Ethical approval

This study was approved by the Institutional Review Board of our institution (Study No: KC14RISI0288).

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Kim, YS., Kim, SE., Bae, SH. et al. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc 25, 2073–2080 (2017). https://doi.org/10.1007/s00167-016-4388-3

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