Department of Orthopaedic Surgery, Washington University, St Louis, MO 63017, USA.
J Shoulder Elbow Surg. 2010 Dec;19(8):1191-8. doi: 10.1016/j.jse.2010.07.017. Epub 2010 Oct 27.
The purpose of this study is to characterize the demographic features and physical function of subjects with asymptomatic rotator cuff tears and to compare their shoulder function with control subjects with an intact rotator cuff.
This study enrolled 196 subjects with an asymptomatic rotator cuff tear and 54 subjects with an intact rotator cuff presenting with a painful rotator cuff tear in the contralateral shoulder. Various demographic features, shoulder function (American Shoulder and Elbow Surgeons score and Simple Shoulder Test score), range of motion, and strength were compared.
The demographic features of the study and control groups were similar. Hand dominance was associated with the presence of shoulder pain (P < .05). Subjects with an intact rotator cuff had greater but clinically insignificant American Shoulder and Elbow Surgeons (P < .05) and Simple Shoulder Test (P < .05) scores than those with an asymptomatic tear. No differences in functional scores, range of motion, or strength were seen between partial-thickness tears (n = 61) and full-thickness tears (n = 135). Of the full-thickness tears, 36 (27%) were classified as small, 85 (63%) as medium, and 14 (10%) as large. No differences were seen in functional scores among full-thickness tears of various sizes.
When asymptomatic, a rotator cuff tear is associated with a clinically insignificant loss of shoulder function compared with an intact rotator cuff. Therefore a clinically detectable decline in shoulder function may indicate an "at-risk" asymptomatic tear. The presence of pain is important in cuff-deficient shoulders for creating a measurable loss of shoulder function. Hand dominance appears to be an important risk factor for pain.
本研究旨在描述无症状肩袖撕裂患者的人口统计学特征和躯体功能，并将其与对侧肩疼痛性肩袖撕裂但肩袖完整的对照组进行比较，以评估其肩部功能。
本研究纳入 196 例无症状肩袖撕裂患者和 54 例对侧肩疼痛性肩袖撕裂但肩袖完整的患者。比较了两组的各项人口统计学特征、肩部功能（美国肩肘外科医师评分和简易肩测试评分）、活动范围和力量。
研究组和对照组的人口统计学特征相似。手优势与肩部疼痛有关（P＜0.05）。肩袖完整的患者的美国肩肘外科医师评分和简易肩测试评分更高，但差异无统计学意义（P＜0.05）。部分厚度撕裂（n=61）和全厚度撕裂（n=135）之间的功能评分、活动范围或力量无差异。全厚度撕裂中，小撕裂 36 例（27%），中撕裂 85 例（63%），大撕裂 14 例（10%）。不同大小的全厚度撕裂之间的功能评分无差异。
在无症状时，肩袖撕裂与肩袖完整相比，肩部功能仅出现临床意义不显著的丧失。因此，肩部功能的临床明显下降可能表明存在“有风险”的无症状撕裂。疼痛的存在对于肩袖缺失的肩部造成可测量的肩部功能丧失很重要。手优势似乎是疼痛的一个重要危险因素。
