Authors:
The MOON Shoulder Group: Kenneth P. Unruh, MD, John E. Kuhn, MD, MS, Rosemary Sanders, BA, Q An, MS, Keith M. Baumgarten, MD, Julie Y. Bishop, MD, Robert H. Brophy, MD, James L. Carey, MD, MPH, Brian G. Holloway, MD, Grant L. Jones, MD, Benjamin C. Ma, MD, Robert G. Marx, MD, MPH, Eric C. McCarty, MD, Souray K. Poddar, MD, Matthew V. Smith, MD, Edwin E. Spencer, MD, Armando F. Vidal, MD, Brian R. Wolf, MD, Rick W. Wright, MD, Warren R. Dunn, MD, MPH
Abstract:
Hypothesis
The purpose of this cross-sectional study is to determine whether the duration of symptoms influences the features seen in patients with atraumatic, full-thickness rotator cuff tears. Our hypothesis is that an increasing duration of symptoms will correlate with more advanced findings of rotator cuff tear severity on magnetic resonance imaging, worse shoulder outcome scores, more pain, decreased range of motion, and less strength.
Methods
We enrolled 450 patients with full-thickness rotator cuff tears in a prospective cohort study to assess the effectiveness of nonoperative treatment and factors predictive of success. The duration of patient symptoms was divided into 4 groups: 3 months or less, 4 to 6 months, 7 to 12 months, and greater than 12 months. Data collected at patient entry into the study included (1) demographic data, (2) history and physical examination data, (3) radiographic imaging data, and (4) validated patient-reported measures of shoulder status. Statistical analysis included a univariate analysis with the Kruskal-Wallis test and Pearson test to identify statistically significant differences in these features for different durations of symptoms.
Results
A longer duration of symptoms does not correlate with more severe rotator cuff disease. The duration of symptoms was not related to weakness, limited range of motion, tear size, fatty atrophy, or validated patient-reported outcome measures.
Conclusions
There is only a weak relationship between the duration of symptoms and features associated with rotator cuff disease.