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Conservatively Treated Symptomatic Rotator Cuff Tendinopathy May Progress to a Tear
Noah J Quinlan1, Jeffrey J Frandsen1, Karch M Smith2
1Orthopaedic Resident, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|August 29, 2022
Summary
Rotator cuff tendinopathy can progress to a tear in 39% of patients within 3.4 years. No specific risk factors were identified for this progression, though longer follow-up intervals showed higher tear rates.
Area of Science:
- Orthopedics
- Radiology
- Musculoskeletal Diseases
Background:
- Rotator cuff tendinopathy is a common shoulder condition.
- Progression to rotator cuff tear can occur, impacting patient outcomes.
- Identifying risk factors for progression is crucial for conservative management strategies.
Purpose of the Study:
- To determine the likelihood of rotator cuff tendinopathy progressing to a tear.
- To identify risk factors associated with this progression.
- To analyze progression rates based on follow-up intervals using magnetic resonance imaging (MRI).
Main Methods:
- Retrospective review of 135 patients with rotator cuff tendinopathy on initial MRI from the Veterans Health Administration database.
- Sequential MRIs of the same shoulder at least 1 year apart were analyzed.
- Demographic and clinical data were collected; tear progression was defined as development of a partial or full-thickness tear on follow-up MRI.
Main Results:
- 39% of patients progressed from tendinopathy to a tear on follow-up MRI (mean 3.4 years).
- Progression rates increased with longer intervals between scans: 32% (1-2 years), 37% (2-5 years), and 54% (>5 years).
- No demographic or clinical factors were significantly associated with progression.
Conclusions:
- Symptomatic rotator cuff tendinopathy has a significant likelihood (39%) of progressing to a tear.
- Progression rates are higher with longer time intervals between diagnostic imaging.
- This study did not identify specific risk factors predicting progression from tendinopathy to tear.
