Radiographic progression of arthritic changes in shoulders with degenerative rotator cuff tears.
BACKGROUND
Very little longitudinal information has been available regarding the relationship of cuff tears and arthritis. The purpose of this study was to determine the midterm risk of and risk factors for rotator cuff tear arthropathy progression in a cohort of subjects with an asymptomatic rotator cuff tear.


METHODS
Baseline (visit 1), 5-year (visit 2), and most recent follow-up (visit 3) radiographs were reviewed in a cohort of 105 subjects enrolled for longitudinal surveillance of asymptomatic degenerative rotator cuff tears and 33 controls. The radiographs were assessed in a blinded, randomized fashion by 3 observers who graded glenohumeral arthritic changes using the Hamada scores, Samilson-Prieto (SPO) scores, and acromiohumeral interval (AHI).


RESULTS
Osteoarthritis (SPO classification), cuff tear arthropathy (Hamada classification), and AHI progressed between visits 1 and 3 (median, 8 years; P < .001 in all cases). SPO progression was not significantly different for partial- vs. full-thickness vs. control baseline tear types (P = .19). Both full-thickness and partial-thickness tears had greater progression in Hamada scores than controls did in the first 5 years of follow-up (P = .02 and P = .03, respectively), but scores did not differ between partial- and full-thickness tears. Tears with and without enlargement did not differ in progression in SPO grade, Hamada grade, or AHI.


CONCLUSIONS
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.
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: p.n.chalmers@gmail.com.
Peter N
PN
Chalmers
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Dane H
DH
Salazar
Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA.
Karen
K
Steger-May
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Aaron M
AM
Chamberlain
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Georgia
G
Stobbs-Cucchi
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Ken
K
Yamaguchi
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Jay D
JD
Keener
D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D010003:Osteoarthritis / Q000145:classification / Q000000981:diagnostic imaging*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging*; D012785:Shoulder Joint / Q000000981:diagnostic imaging*
Rotator cuff tear; degenerative joint disease; natural history; osteoarthritis; rotator cuff tear arthropathy; shoulder pain