Partial rotator cuff tears in adolescents: factors affecting outcomes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Adolescent Health

Background:

• Rotator cuff tears are prevalent in adults but rare in adolescents, with limited treatment data.
• Adolescent rotator cuff injuries present unique challenges due to fewer established treatment protocols and outcome reports.

Purpose of the Study:

• To investigate adolescent rotator cuff tears, including associated pathologies.
• To report on treatment outcomes for adolescent rotator cuff tears.

Main Methods:

• Retrospective comparative analysis of adolescent patients (2008-2010) with rotator cuff tears diagnosed via MRI or arthroscopy.
• Patients categorized into nonoperative and operative treatment groups; demographic and diagnostic variables compared.
• Outcome measures included QuickDASH, QuickDASH Sports module, and Single Assessment Numerical Evaluation (SANE) post-treatment.

Main Results:

• Fifty-three adolescents (mean age 15.8) with partial articular-sided tendon avulsions were included.
• 57% of patients failed conservative physical therapy and required surgery; associated pathology increased likelihood of surgery (OR 1.8).
• No significant difference in QuickDASH, SANE, or Sports module scores between operative and nonoperative groups; strong negative correlation between SANE and Sports module scores.

Conclusions:

• Isolated partial articular-sided rotator cuff avulsions can be managed nonoperatively with physical therapy, allowing return to sports.
• Associated pathology reduces nonoperative treatment success in adolescents.
• Surgery can improve pain and daily living post-failed conservative care, but adolescent athletes may experience residual sports-related shoulder complaints.