Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Arthroscopy. 2023 Jul;39(7):1611-1617. doi: 10.1016/j.arthro.2023.02.008. Epub 2023 Feb 18.
To investigate the prevalence of a contralateral rotator cuff tear (RCT) in patients with a symptomatic RCT requiring repair and to determine whether findings from magnetic resonance imaging (MRI) of the affected shoulder can predict the presence of a contralateral tear.
Patients with atraumatic RCTs who had undergone arthroscopic repair between March 2019 and February 2021 were reviewed in this study. MRI of both shoulder joints was performed to evaluate the bilaterality of RCT. Demographic factors and MRI findings of index shoulders were assessed using logistic regression analysis to reveal any correlations with the presence of RCT in the contralateral shoulder.
A total of 428 patients were enrolled in this study. When the affected shoulders had a posterosuperior rotator cuff (PSRC) or subscapularis tear including either an isolated or combined tear, 63.6% and 67.8% had the same tears on the contralateral side, respectively. A contralateral-side tear was found in 74.6% (185/248) of symptomatic cases and 44.8% (65/145) of asymptomatic cases, which represents a significant difference (P < .001). Logistic regression analysis revealed that age ≥67.5 years, tear size ≥17 mm, Goutallier grade ≥1.5, and Patte grade ≥1.5 were found to be indicative of potential contralateral PSRC tears. By contrast, the presence of a subscapularis tear in the affected shoulder was the only significant risk factor in predicting a potential subscapularis tear in the contralateral shoulder.
Among patients with a symptomatic RCT requiring arthroscopic repair, 63.6% with a PSRC tear and 67.8% with a subscapularis tear in the affected shoulder were found to have a similar tear in the contralateral shoulder regardless of symptoms. Age, tear size, extent of retraction, fatty infiltration of PSRC tears, and the presence of subscapularis tears were identified as factors predictive of tears on the contralateral side.
Level IV, case series.
调查需要修复的症状性肩袖撕裂（RCT）患者对侧肩袖撕裂（RCT）的发生率，并确定受影响肩部的磁共振成像（MRI）检查结果是否能预测对侧撕裂的存在。
本研究回顾性分析了 2019 年 3 月至 2021 年 2 月间接受关节镜修复术的外伤性 RCT 患者。对双侧肩关节进行 MRI 检查，以评估 RCT 的双侧性。采用 logistic 回归分析评估指数肩的人口统计学因素和 MRI 结果，以揭示与对侧肩 RCT 存在的相关性。
共纳入 428 例患者。当患侧肩出现后上肩袖（PSRC）或肩胛下肌撕裂（包括单一或合并撕裂）时，对侧分别有 63.6%和 67.8%出现相同撕裂。在症状性病例中，74.6%（185/248）发现对侧撕裂，在无症状病例中为 44.8%（65/145），差异有统计学意义（P<0.001）。logistic 回归分析显示，年龄≥67.5 岁、撕裂大小≥17mm、Goutallier 分级≥1.5 级和 Patte 分级≥1.5 级与潜在对侧 PSRC 撕裂相关。相比之下，患侧肩胛下肌撕裂是预测对侧肩胛下肌撕裂的唯一显著危险因素。
在需要关节镜修复的症状性 RCT 患者中，63.6%的 PSRC 撕裂和 67.8%的肩胛下肌撕裂患者的患侧肩部发现有类似的对侧撕裂，无论症状如何。年龄、撕裂大小、回缩程度、PSRC 撕裂的脂肪浸润以及肩胛下肌撕裂的存在被确定为对侧撕裂的预测因素。
IV 级，病例系列研究。
