Fig. 1
Prevalence of rotator cuff tear on dominant limb in asymptomatic subjects that have undergone ultrasound examination, in the various age groups. (Milgrom, 1995)
In a similar study, performed on 411 shoulders of asymptomatic subjects that had more than 50 years old, Tempelhof [32] observed full thickness tears in 23 % of the cases.
Sher et al. [33] have subjected to a MRI evaluation 192 asymptomatic shoulders (96 subjects). The authors have observed a partial or a complete cuff tear in 20 % and in 15 % of the cases, respectively. Furthermore, they have shown that the prevalence of tears increases with the age and it is 4 % in subjects younger than 40 years and 54 % in those older than 60 years (Fig. 2).
Fig. 2
Prevalence of partial and full thickness tears in asymptomatic subjects that have undergone MRI examination, in the various age groups. (Sher, 1995)
Studies on Symptomatic Patients
Ultrasound-based studies [38–49] have shown that the prevalence of full thickness rotator cuff tear in subjects older than 40 years old with pain and/or functional limitation and/or loss of strength of the shoulder is between 16 and 69 %. The studies of Crass et al. [39] and Minagawa et al. [40] have enrolled big populations of patients: 500 and 1328 shoulders, respectively. In both, the prevalence of rotator cuff tear has been 22 %. Moreover, Minagawa et al. [40] have divided their population in age-related groups and have shown that the ones aged under 50 years old had a prevalence of tears of 0 %, the ones aged between 50 and 59 of 11 %, between 60 and 69 of 15 %, and between 70 and 79 of 26 %. The prevalence in patients of more than 80 years raised up to 37 %.
Yamaguchi et al. [58] in 2006 have performed an echographic study of both shoulders in 558 patients with symptoms only at one of the two joints; 36 % of the studied subjects had normal cuffs, 34 % of the population had unilateral tears, and 30 % a bilateral ones. The authors have observed that a cuff tear was present in 64 % of symptomatic patients. Moreover, subjects with unilateral full thickness lesions had the possibility to have a partial or complete tear of the contralateral cuff in 20.8 % and 35.5 % of cases, respectively. On the contrary, in the case of incomplete tears, the probabilities to have a partial or full thickness lesion of the contralateral cuff were 29.3 % and 4.3 %, respectively.
As it was already noted in previous studies [5, 6, 8, 9, 31, 33, 40, 57], Yamaguchi et al. [58] showed that the prevalence of rotator cuff tear increases with age: in fact the group of patients without rupture had a mean age of 48 years, the one with unilateral lesions of 58 years and the one with bilateral tears of 67 years. Figures 3 and 4, taken from the study of Yamaguchi et al. [58], display the percentages of partial and full thickness tears in the patients with unilateral and bilateral disease.
Fig. 3
Percentages of partial and full thickness tears in patients with unilateral tear (Yamaguchi et al. [58])
Fig. 4
Percentages of partial tears, full thickness tears and partial associated to full thickness tears, in the group of patients with a bilateral cuff lesions (Yamaguchi et al. [58])
Study on Mixed Population (Asymptomatic and Symptomatic)
Yamamoto [57] in 2010 has studied 683 patients from a little Japanese city by echography (1366 shoulders). The population included subjects aged between 22 and 87 years old (mean 58 years). The prevalence of full thickness rotator cuff tear has been 21 %, dropping to 17 % in asymptomatic patients and increasing to 36 % in symptomatic ones. Even in this study the prevalence increased with age reaching 80 % in patients aged more than 80 (Fig. 5).
Fig. 5
Prevalence of rotator cuff tear in general population (Yamamoto 2010)
Our Experience
Age, Sex, Side, and Dominant Arm
Our data have been taken out of the examination of 718 consecutive patients (341 M: 47.5 % and 377 F: 52.5 %) that undergone surgical repair of full thickness rotator cuff tears. Mean age of the patients was 65 years old (range: 37–84 years, standard deviation (SD): 8.65). Right side was affected in 74.2 % of the patients and left one in 25.8 %. In 74.5 % of the patients, the tear involved the shoulder of the dominant arm. In particular way, in 72.9 % of this cases the lesion was at the right shoulder, whereas in 1.6 % it was at the left one (Tables 1 and 2).
Table 1
Data of our 718 patients (sex, age)
n. | % | SD | |
|---|---|---|---|
Asymptomatic patients | 718 | 100 | |
Males | 341 | 47.49 | |
Females | 377 | 52.51 | |
Average age and range | 65 [37–84] | 8.65 | |
Males’ average age and range | 64 [37–84] | 9.05 | |
Females’ average age and range | 66 [40–84] | 8.23 |
Table 2
Data of our 718 patients (dominant limb, tear side)
% | ||
|---|---|---|
Right-handed pts | 96.77 | |
Right-handed pts with a Right tear | 72.9 | |
Left-handed pts | 3.23 | |
Left-handed pts with a Left tear | 1.62 | |
Tear on dominant limb | 74.52 | |
Right tears | 74.2 | |
Left tears | 25.8 | |
Males | ||
Right tears | 76.76 | |
Left tears | 23.24 | |
Females | ||
Right tears | 72.62 | |
Left tears | 27.38 |
In the subgroup including male patients, the mean age was 64 years (range: 37–84 years; SD: 9.05) and the involved side was the right one in 76.8 % of the cases. In the subgroup of females, mean age was 66 years (range: 40–84 years; SD: 8.23). Right shoulder was involved in 72.6 % of the cases (Tables 1 and 2).
Occupation
22.3 % of the patients were, or had been, manual laborers (workers, construction workers, mechanics, cleaners, metalworkers, painters, farmers, etc.). 54.2 % of the patients were employers, businessmen, professionals, retailers. Finally, 23.6 % of the patients who undergone surgical repair were housewives (Table 3).
Table 3
Data of the work activities of our patients
Occupation | % |
|---|---|
Heavy (upper limb) | 22.26 |
Not heavy (upper limb) | 54.19 |
Housewife or pensioners | 23.55 |
Tear Size
Out of simplicity, in this paragraph the tears were divided in small, large, and massive. We did not consider the various possible shapes of the lesions, nor have contemplated the patients that only had a partial lesion of the cuff (Table 4).
Table 4
Data about tear size
Tear size | n. | % | |
|---|---|---|---|
Small | 120 | 16.71 | |
Average age | 62 | ||
Max–min age | 78–41 | ||
SD | 8.95 | ||
Males | 53 | 44.17 | |
Females | 67 | 55.83 | |
Large | 446 | 62.12 | |
Average age | 65 | ||
Max–min age | 84–37 | ||
SD | 8.58 | ||
Males
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