Status of the contralateral rotator cuff in patients undergoing rotator cuff repair.
BACKGROUND
Although the prevalence of rotator cuff tear (RCT) in the general population has been analyzed, little information is available on the status of the opposite-side rotator cuff in patients who have undergone arthroscopic rotator cuff repair.


OBJECTIVE
To identify the characteristics of the contralateral shoulder and to identify factors associated with RCT of the contralateral shoulder in patients who underwent surgery for symptomatic RCT. The hypothesis was that the prevalence of RCT in the contralateral shoulder would be higher in patients with increasingly larger cuff tears requiring surgical intervention.


METHODS
Case series; Level of evidence, 4.


METHODS
The study cohort consisted of 140 patients with RCT who underwent arthroscopic rotator cuff repair. Opposite-shoulder rotator cuff tendons of all patients were evaluated by ultrasonography. Demographic information and factors related to contralateral RCT were investigated, and risk factors associated with contralateral RCT were assessed.


RESULTS
Of the 140 patients who underwent arthroscopic rotator cuff repair, 54 (38.6%) had an RCT of the contralateral shoulder. Of 51 patients with partial-thickness and small-sized full-thickness tears of the operated shoulder, 35 (68.6%) had no tears; 14 (27.5%) had partial-thickness tears; and 2 (3.9%) had small-sized full-thickness tears of the contralateral shoulder. Of 75 patients with medium-sized full-thickness tears, 43 (57.3%) had no tears; 12 (16%) had partial-thickness tears; and 20 (26.7%) had full-thickness tears of the contralateral shoulder. Of 14 patients with large to massive full-thickness tears, 8 (57.1%) had no tears; 1 (7.1%) had a partial-thickness tear; and 5 (35.7%) had full-thickness tears of the contralateral shoulder. The prevalence of RCT of the contralateral shoulder differed significantly among groups classified by tear size (P=.007). The mean American Shoulder and Elbow Surgeons score was significantly lower in the RCT than in the nontear group (55.8±16.9 vs 61.6±13.3; P=.03). Of 29 subjects with symptomatic tears involving the nondominant arm, 17 (58.6%) had contralateral asymptomatic RCT, compared with 37 of 111 (33.3%) subjects with symptomatic tears involving the dominant arm (P=.007).


CONCLUSIONS
The prevalence of RCT of the contralateral asymptomatic shoulder tends to be higher in patients with more symptomatic RCT on one side, in patients with medium-sized or larger RCT in the operated shoulder, and in patients with symptomatic RCT in the nondominant arm.
Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
Kyung-Han
KH
Ro
Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
Jong-Hoon
JH
Park
Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
Soon-Hyuck
SH
Lee
Barunsesang Hospital, Seongnam, Korea.
Dong-Ik
DI
Song
Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
Ha-Joon
HJ
Jeong
Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea drshoulder@korea.ac.kr.
Woong-Kyo
WK
Jeong
D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D012421:Rupture; D012782:Shoulder / Q000601:surgery*
contralateral side; rotator cuff tendon; shoulder; ultrasonography