Chalmers and colleagues followed radiographic arthritis in shoulders with asymptomatic degenerative cuff tears to measure how often it progresses toward cuff tear arthropathy and which tear features predict it.
Level II prognosis study of 138 patients from a Washington University surveillance cohort, radiographs over a median 8 years. NIH‑funded. Three authors report consulting, research support or royalties from Arthrex, Zimmer, Tornier or Genesis.
Key Findings
Arthritic change progressed but stayed minimal over a median 8 years. Hamada grade 1 fell from 93% to 77% of patients imaged, and Samilson‑Prieto grade 0 from 87% to 70%.
Mean acromiohumeral interval narrowed from 8.9 to 7.7 mm. Like both grades, it changed between baseline and 5 years but not from 5 years to final follow‑up.
Baseline tear type did not significantly alter Samilson‑Prieto progression (p = 0.19) or Hamada progression overall (p = 0.09).
In post hoc tests, partial tears (p = 0.02) and full tears (p = 0.03) progressed more in Hamada grade than controls over the first 5 years. By final follow‑up the differences were not significant.
Among 67 full‑thickness tears, 52 enlarged. Enlargement was not associated with progression in Samilson‑Prieto grade, Hamada grade or acromiohumeral interval (all p > 0.09).
Most tears were small to medium with little baseline arthritis. The authors note this cohort may have been at low risk, which limits generalizability, and they did not relate arthritic change to symptoms.
Authors' conclusion
Glenohumeral arthritic changes progress significantly but remain minimal within an 8-year period in early to moderate degenerative cuff disease. Whereas the presence of a rotator cuff tear influences progression in Hamada grade, the magnitude of radiographic progression is not influenced by tear severity or enlargement at midterm time points.
Chalmers and colleagues followed radiographic arthritis in shoulders with asymptomatic degenerative cuff tears to measure how often it progresses toward cuff tear arthropathy and which tear features predict it.
Level II prognosis study of 138 patients from a Washington University surveillance cohort, radiographs over a median 8 years. NIH‑funded. Three authors report consulting, research support or royalties from Arthrex, Zimmer, Tornier or Genesis.
Key Findings
Arthritic change progressed but stayed minimal over a median 8 years. Hamada grade 1 fell from 93% to 77% of patients imaged, and Samilson‑Prieto grade 0 from 87% to 70%.
Mean acromiohumeral interval narrowed from 8.9 to 7.7 mm. Like both grades, it changed between baseline and 5 years but not from 5 years to final follow‑up.
Baseline tear type did not significantly alter Samilson‑Prieto progression (p = 0.19) or Hamada progression overall (p = 0.09).
In post hoc tests, partial tears (p = 0.02) and full tears (p = 0.03) progressed more in Hamada grade than controls over the first 5 years. By final follow‑up the differences were not significant.
Among 67 full‑thickness tears, 52 enlarged. Enlargement was not associated with progression in Samilson‑Prieto grade, Hamada grade or acromiohumeral interval (all p > 0.09).
Most tears were small to medium with little baseline arthritis. The authors note this cohort may have been at low risk, which limits generalizability, and they did not relate arthritic change to symptoms.
Authors' conclusion
Glenohumeral arthritic changes progress significantly but remain minimal within an 8-year period in early to moderate degenerative cuff disease. Whereas the presence of a rotator cuff tear influences progression in Hamada grade, the magnitude of radiographic progression is not influenced by tear severity or enlargement at midterm time points.