From the Vanderbilt University School of Medicine, Nashville, Tennessee (AZG); Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (AS, NBJ); Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee (PK); Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (GDA, JEK, NBJ); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee (GDA); King Edward Memorial Hospital, Hamilton, Bermuda (LDH); Orthopedic Institute of Sioux Falls, Sioux Falls, South Dakota (KMB); Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (EM); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ).
Am J Phys Med Rehabil. 2021 Apr 1;100(4):331-336. doi: 10.1097/PHM.0000000000001684.
Although rotator cuff tear is one of the most common musculoskeletal disorders, its etiology is poorly understood. We assessed factors associated with the presence of rotator cuff tears in a cohort of patients with shoulder pain.
From February 2011 to July 2016, a longitudinal cohort of patients with shoulder pain was recruited. Patients completed a detailed questionnaire in addition to a magnetic resonance imaging scan and a clinical shoulder evaluation. The association of multiple factors associated with rotator cuff tears was assessed using multivariate logistic regression.
In our cohort of 266 patients, 61.3% of patients had a rotator cuff tear. Older age (per 1 yr: odds ratio = 1.03, 95% confidence interval = 1.02-1.07), involvement of the dominant shoulder (odds ratio = 2.02, 95% confidence interval = 1.16-3.52), and a higher body mass index (per 1 kg/m2: odds ratio = 1.06, 95% confidence interval = 1.03-1.12) were independently associated with rotator cuff tears. Sex, depression, smoking status, shoulder use at work, hypertension, and diabetes were not significantly associated with rotator cuff tear.
In a cohort of patients with shoulder pain, we identified older age, involvement of the dominant shoulder, and a higher body mass index to be independently associated with rotator cuff tear. The mechanism of how these factors possibly lead to rotator cuff tears needs further research.
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Upon completion of this article, the reader should be able to: (1) Identify factors associated with an increased risk of developing rotator cuff tears in adults; (2) Describe the current epidemiological trends of rotator cuff tears in the United States; and (3) Discuss the pathophysiological role of aging in the development of nontraumatic rotator cuff tears.
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The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
肩袖撕裂是最常见的肌肉骨骼疾病之一,但病因尚不清楚。我们评估了患有肩痛的患者队列中与肩袖撕裂存在相关的因素。
从 2011 年 2 月至 2016 年 7 月,招募了患有肩痛的纵向队列患者。除了磁共振成像扫描和临床肩部评估外,患者还完成了详细的问卷。使用多变量逻辑回归评估与肩袖撕裂相关的多种因素的关联。
在我们的 266 名患者队列中,61.3%的患者有肩袖撕裂。年龄每增加 1 岁(比值比=1.03,95%置信区间=1.02-1.07)、优势肩受累(比值比=2.02,95%置信区间=1.16-3.52)和较高的体重指数(每增加 1kg/m2:比值比=1.06,95%置信区间=1.03-1.12)与肩袖撕裂独立相关。性别、抑郁、吸烟状况、工作中使用肩部、高血压和糖尿病与肩袖撕裂无显著相关性。
在患有肩痛的患者队列中,我们发现年龄较大、优势肩受累和较高的体重指数与肩袖撕裂独立相关。这些因素如何导致肩袖撕裂的机制需要进一步研究。
索取 CME 学分:完成在线自我评估活动和评估http://www.physiatry.org/JournalCME。
CME 目标:完成本文后,读者应能够:(1)确定与成年人肩袖撕裂风险增加相关的因素;(2)描述美国肩袖撕裂的当前流行病学趋势;(3)讨论衰老在非创伤性肩袖撕裂发展中的病理生理作用。
高级。
学术物理治疗医师协会由继续医学教育认证委员会认可,为医生提供继续医学教育。学术物理治疗医师协会将这项基于期刊的 CME 活动指定为最多 1.0 个 AMA PRA 类别 1 学分(™)。医生只能要求与其参与活动程度相符的学分。