, Volume 97, Supplement 1, pp 69–72 | Cite as

The impact of aging on rotator cuff tear size

  • S. Gumina
  • S. CarboneEmail author
  • V. Campagna
  • V. Candela
  • F. M. Sacchetti
  • G. Giannicola
Original Article



The aim of our study was to establish if aging influences rotator cuff tear size.

Patients and methods

We studied 586 consecutive patients (280 M, 306 F) mean age 59 years old (range 46–73) who underwent arthroscopic rotator cuff repair. Tear size was determined during surgery. For the purpose of our study, patients were divided into two groups based on age older than 60 years. A multinomial logistic regression model was applied to explore the association between age older than 60 years and tear size. We used the ANCOVA method to determine whether the aging influences the severity of the tear. All analyses were adjusted for gender.


Age older than 60 years was associated with a twofold higher overall risk of tear occurrence (OR = 2.12, 95 % CI 1.44–3.01). While no association was detected between age older than 60 years and the probability of a small tear (OR = 0.58, 95 % CI 0.27–1.07), subjects older than 60 years were twice more likely to experience a large tear (OR = 2.29, 95 %CI 1.51–3.27) and three times more likely to experience a massive tear (OR = 3.09, 95 % CI 2.07–5.38) as opposed to younger subjects. Mean age significantly increased from small tear (53.8 years) to large tear (66.8 years) to massive tear (69.4 years) patients (ANCOVA: F(2, 437) = 16.487, p = 1.51 × 10−7).


We found a significantly older mean age in patients with a more severe tear. Our data provide and confirm evidence that aging is a significant risk factor for the occurrence and severity of rotator cuff tears.


Rotator Cuff tear Natural history Pathogenesis Cuff tear size 


Conflict of interest



  1. 1.
    Neer CS (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54:41–50PubMedGoogle Scholar
  2. 2.
    Bigliani LU, Morrison DS, April EW (1986) The morphology of the acromion and its relationship to the rotator cuff tear. Orthop Trans 10:228–232Google Scholar
  3. 3.
    Nové-Josserand L, Walch G, Adeleine P, Courpron P (2005) Effect of age on the natural history of the shoulder: a clinical and radiological study in the elderly. Rev Chir Orthop 91:508–514PubMedGoogle Scholar
  4. 4.
    Ogawa K, Yoshida A, Inokuchi W, Naniwa T (2005) Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Shoulder Elbow Surg 14:591–598. doi: 10.1016/j.jse.2005.03.007 PubMedCrossRefGoogle Scholar
  5. 5.
    Yamagouchi K, Ditsion K, Middleton W, Hildebolt C, Galatz L, Teefey S (2006) The demographic and morphological features of rotator cuff disease. J Bone Joint Surg 88:1699–1704CrossRefGoogle Scholar
  6. 6.
    Yamagouchi K, Tetro M, Blam O, Evanoff B, Teefey S, Middleton W (2001) Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg 10:199–203CrossRefGoogle Scholar
  7. 7.
    Brooks CH, Revell WJ, Heatley FW (1992) A quantitative histological study of the vascularity of the rotator cuff tendon. J Bone Joint Surg Br 74:151–153PubMedGoogle Scholar
  8. 8.
    Harvie P, Ostlere SJ, Teh J, McNally EG, Clipsham K, Burston BJ, Pollard TBC, Carr AJ (2004) Genetic influences in the aetiology of tears of the rotator cuff. J Bone Joint Surg Br 86:696–700. doi: 10.1302/0301-620X.86B5.14747 PubMedCrossRefGoogle Scholar
  9. 9.
    Jerosch J, Muller T, Castro WH (1991) The incidence of rotator cuff rupture. An anatomic study. Acta Orthop Belg 57:124–129PubMedGoogle Scholar
  10. 10.
    DePalma AF, White JB, Callery G (1950) Degenerative lesions of the shoulder joint at various age groups which are compatible with good function. Instr Course Lect 7:168–180Google Scholar
  11. 11.
    Fukuda H, Misaka M, Yamanaka K (1987) Incomplete thickness rotator cuff tears diagnosed by subacromial bursography. Clin Orthop Relat Res 223:51–58PubMedGoogle Scholar
  12. 12.
    Fukuda H, Hamada K, Yamanaka K (1990) Pathology and pathogenesis of bursal-side rotator cuff tears viewed from en bloc histologic sections. Clin Orthop Relat Res 254:75–80PubMedGoogle Scholar
  13. 13.
    Milgrom C, Schaffer M, Gilbert S, van Holsbeeck M (1995) Rotator cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 77:296–298PubMedGoogle Scholar
  14. 14.
    Snyder SJ (ed) (2003) Arthroscopic classification of rotator cuff lesions and surgical decision making. In: Shoulder arthroscopy, 2nd edn. Philadelphia, Lippincott Williams & Wilkins, pp 201–207Google Scholar
  15. 15.
    Mochizuki T, Sugaya H, Uomizu M, Maeda K, Matsuki K, Sekiya I, Muneta T, Akita K (2008) Humeral insertion of supraspinatus and infraspinatus. New anatomical findings regarding the footprint of the rotator cuff. J Bone Joint Surg 90:962–969PubMedCrossRefGoogle Scholar
  16. 16.
    Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop 304:78–83PubMedGoogle Scholar
  17. 17.
    Chard M, Hazleman BL (1987) Shoulder disorders in the elderly (a hospital study). Ann Rheum Dis 46:684–687PubMedCrossRefGoogle Scholar
  18. 18.
    Chakravarty K, Webley M (1990) Disorders of the shoulder: an often unrecognized cause of disability in elderly people. BMJ 300:848–849PubMedCrossRefGoogle Scholar
  19. 19.
    Codman EA, Akerson IB (1931) The pathology associated with rupture of the supraspinatus tendon. Ann Surg 93:348–359PubMedCrossRefGoogle Scholar
  20. 20.
    Cotton RE, Rideout DF (1995) Tears of humeral rotator cuff. A radiological and pathological necropsy survey. J Bone Joint Surg 77:296–298Google Scholar
  21. 21.
    Petersson CJ (1983) Degeneration of the gleno-humeral joint. An anatomical study. Acta Orthop Scand 54:277–283PubMedCrossRefGoogle Scholar
  22. 22.
    Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB (1995) Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg 77:10–15PubMedGoogle Scholar
  23. 23.
    Middleton WD, Reinus WR, Tatty WG et al (1986) Ultrasonographic evaluation of the rotator cuff and biceps tendon. J Bone Joint Surg 68:440–450PubMedGoogle Scholar
  24. 24.
    Safran O, Schroeder J, Bloom R, Weil Y, Milgrom C (2011) Natural history of nonoperatively treated symptomatic rotator cuff tears in patients 60 years old or younger. Am J Sports Med 39:709–714CrossRefGoogle Scholar
  25. 25.
    Harryman DT 2nd, Hettrich CM, Smith KL, Campbell B, Sidles JA, Matsen FA 3rd (2003) A prospective multipractice investigation of patients with full-thickness rotator cuff tears: the importance of comorbidities, practice, and other covariables on self-assessed shoulder function and health status. J Bone Joint Surg Am 85:690–696PubMedGoogle Scholar
  26. 26.
    Carbone S, Gumina S, Arceri V, Campagna V, Fagnani C, Postacchini F (2011) The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes. J Shoulder Elbow Surg. doi: 10.1016/j.jse.2011.01.039
  27. 27.
    Gumina S, Arceri V, Carbone S, Albino P, Passaretti D, Campagna V, Fagnani C, Postacchini F (2013) The association between arterial hypertension and rotator cuff tear: the influence on rotator cuff tear sizes. J Shoulder Elbow Surg 22:229–232. doi: 10.1016/j.jse.2012.05.023 PubMedCrossRefGoogle Scholar

Copyright information

© Istituto Ortopedico Rizzoli 2013

Authors and Affiliations

  • S. Gumina
    • 1
  • S. Carbone
    • 1
    Email author
  • V. Campagna
    • 2
  • V. Candela
    • 1
  • F. M. Sacchetti
    • 1
  • G. Giannicola
    • 1
  1. 1.Department of Orthopaedic and TraumatologyUniversity of Rome, SapienzaRomeItaly
  2. 2.Department of Orthopaedic and TraumatologyPoliclinico Militare CelioRomeItaly

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