Prospective cohort study of 229 patients aged ≤65 years with an asymptomatic rotator cuff tear in one shoulder and a painful tear in the other, followed annually with physical exam and ultrasound for a median of 7.1 years. The study quantifies rates and predictors of tear enlargement, pain development, and fatty muscle degeneration in untreated asymptomatic tears.
When you see an asymptomatic full-thickness rotator cuff tear in a patient under 65, counsel them that 80% of these tears will enlarge within 8 years and over half will become painful — especially if the tear is in the dominant shoulder, is >20-25 mm, or shows anterior cable disruption, where the authors suggest earlier surgical consideration is warranted before irreversible muscle degeneration sets in.
Prospective cohort study of 229 patients aged ≤65 years with an asymptomatic rotator cuff tear in one shoulder and a painful tear in the other, followed annually with physical exam and ultrasound for a median of 7.1 years. The study quantifies rates and predictors of tear enlargement, pain development, and fatty muscle degeneration in untreated asymptomatic tears.
When you see an asymptomatic full-thickness rotator cuff tear in a patient under 65, counsel them that 80% of these tears will enlarge within 8 years and over half will become painful — especially if the tear is in the dominant shoulder, is >20-25 mm, or shows anterior cable disruption, where the authors suggest earlier surgical consideration is warranted before irreversible muscle degeneration sets in.