title: The duration of symptoms does not correlate with rotator cuff tear severity or other patient-related features: a cross-sectional study of patients with atraumatic, full-thickness rotator cuff tears.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical School, Nashville, TN, USA.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Unruh
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical School, Nashville, TN, USA. Electronic address: j.kuhn@vanderbilt.edu.
authors.forename: John E
authors.initials: JE
authors.lastname: Kuhn
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical School, Nashville, TN, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Sanders
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical School, Nashville, TN, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: An
authors.affiliation: Orthopaedic Institute, Sioux Falls, SD, USA.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Baumgarten
authors.affiliation: Department of Orthopaedics, The Ohio State University, Columbus, OH, USA.
authors.forename: Julie Y
authors.initials: JY
authors.lastname: Bishop
authors.affiliation: Division of Sports Medicine, Department of Orthopedics, Washington University, St. Louis, MO, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics, University of Pennsylvania, Philadephia, PA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Carey
authors.affiliation: Knoxville Orthopedic Clinic, Knoxville, TN, USA.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Holloway
authors.affiliation: Department of Orthopaedics, The Ohio State University, Columbus, OH, USA.
authors.forename: Grant L
authors.initials: GL
authors.lastname: Jones
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Ma
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Marx
authors.affiliation: Division of Sports Medicine, University of Colorado, Denver, CO, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: McCarty
authors.affiliation: Division of Sports Medicine, University of Colorado, Denver, CO, USA.
authors.forename: Souray K
authors.initials: SK
authors.lastname: Poddar
authors.affiliation: Division of Sports Medicine, Department of Orthopedics, Washington University, St. Louis, MO, USA.
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Smith
authors.affiliation: Knoxville Orthopedic Clinic, Knoxville, TN, USA.
authors.forename: Edwin E
authors.initials: EE
authors.lastname: Spencer
authors.affiliation: Division of Sports Medicine, University of Colorado, Denver, CO, USA.
authors.forename: Armando F
authors.initials: AF
authors.lastname: Vidal
authors.affiliation: Division of Sports Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Wolf
authors.affiliation: Division of Sports Medicine, Department of Orthopedics, Washington University, St. Louis, MO, USA.
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
authors.affiliation: Division of Sports Medicine, University of Wisconsin, Madison, WI, USA.
authors.forename: Warren R
authors.initials: WR
authors.lastname: Dunn
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000473:pathology*; D013708:Tendon Injuries / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013997:Time Factors
keywords: Rotator cuff tear; cross-sectional study; duration of symptoms