To investigate the prevalence of a contralateral rotator cuff tear (RCT) in patients with a symptomatic RCT requiring repair and to determine whether findings from magnetic resonance imaging (MRI) of the affected shoulder can predict the presence of a contralateral tear.
Patients with atraumatic RCTs who had undergone arthroscopic repair between March 2019 and February 2021 were reviewed in this study. MRI of both shoulder joints was performed to evaluate the bilaterality of RCT. Demographic factors and MRI findings of index shoulders were assessed using logistic regression analysis to reveal any correlations with the presence of RCT in the contralateral shoulder.
A total of 428 patients were enrolled in this study. When the affected shoulders had a posterosuperior rotator cuff (PSRC) or subscapularis tear including either an isolated or combined tear, 63.6% and 67.8% had the same tears on the contralateral side, respectively. A contralateral-side tear was found in 74.6% (185/248) of symptomatic cases and 44.8% (65/145) of asymptomatic cases, which represents a significant difference (P < .001). Logistic regression analysis revealed that age ≥67.5 years, tear size ≥17 mm, Goutallier grade ≥1.5, and Patte grade ≥1.5 were found to be indicative of potential contralateral PSRC tears. By contrast, the presence of a subscapularis tear in the affected shoulder was the only significant risk factor in predicting a potential subscapularis tear in the contralateral shoulder.
Among patients with a symptomatic RCT requiring arthroscopic repair, 63.6% with a PSRC tear and 67.8% with a subscapularis tear in the affected shoulder were found to have a similar tear in the contralateral shoulder regardless of symptoms. Age, tear size, extent of retraction, fatty infiltration of PSRC tears, and the presence of subscapularis tears were identified as factors predictive of tears on the contralateral side.
Level of Evidence
IV, case series.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Arthroscopy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Symptoms of pain do not correlate with rotator cuff tear severity: A cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear.J Bone Joint Surg Am. 2014; 96: 793-800
- Arthroscopic repair of anterosuperior massive rotator cuff tears: Does repair integrity affect outcomes?.Am J Sports Med. 2017; 45: 1762-1768
- Status of the contralateral rotator cuff in patients undergoing rotator cuff repair.Am J Sports Med. 2015; 43: 1091-1098
- Prevalence and risk factors of a rotator cuff tear in the general population.J Shoulder Elbow Surg. 2010; 19: 116-120
- The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders.J Bone Joint Surg Am. 2006; 88: 1699-1704
- Asymptomatic rotator cuff tears.JBJS Rev. 2019; 7: e9
- Symptomatic progression of asymptomatic rotator cuff tears: A prospective study of clinical and sonographic variables.J Bone Joint Surg Am. 2010; 92: 2623-2633
- The natural history of asymptomatic rotator cuff tears: A three-year follow-up of fifty cases.J Bone Joint Surg Am. 2013; 95: 1249-1255
- Natural history of asymptomatic rotator cuff tears: A longitudinal analysis of asymptomatic tears detected sonographically.J Shoulder Elbow Surg. 2001; 10: 199-203
- Arthroscopic partial repair of irreparable rotator cuff tears: Factors related to greater degree of clinical improvement at 2 years of follow-up.Arthroscopy. 2017; 33: 1949-1955
- Quality of life and functional results of arthroscopic partial repair of irreparable rotator cuff tears.Arthroscopy. 2017; 33: 261-268
- Indications for repair of full-thickness rotator cuff tears.Am J Sports Med. 2007; 35: 1007-1016
- Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 56-62
- Use of preoperative magnetic resonance imaging to predict rotator cuff tear pattern and method of repair.Arthroscopy. 2005; 21: 1428
- Classification of rotator cuff lesions.Clin Orthop Relat Res. 1990; : 81-86
- Risk factors of chronic subscapularis tendon tear.Clin Shoulder Elbow. 2022; 25: 257-264
- Fatty degeneration of the muscles of the rotator cuff: Assessment by computed tomography versus magnetic resonance imaging.J Shoulder Elbow Surg. 1999; 8: 599-605
- Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan.Clin Orthop Relat Res. 1994; : 78-83
- Posterior decentering of the humeral head in patients with arthroscopic rotator cuff repair.Clin Shoulder Elbow. 2022; 25: 22-27
- Functional outcomes after bilateral arthroscopic rotator cuff repair.J Shoulder Elbow Surg. 2016; 25: 1668-1673
- The prevalence of rotator cuff tears: Is the contralateral shoulder at risk?.Am J Sports Med. 2014; 42: 826-830
- Bilateral arthroscopic rotator cuff repair using a single-stage procedure.Orthopedics. 2015; 38: e423-e427
- Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: A study of patients with arthroscopically verified cuff tears 22 years ago.J Shoulder Elbow Surg. 2018; 27: e68-e74
- Prevalence of asymptomatic rotator cuff tear and their related factors in the Korean population.J Shoulder Elbow Surg. 2017; 26: 30-35
- Rotator cuff tears in asymptomatic individuals: A clinical and ultrasonographic screening study.Eur J Radiol. 2004; 51: 263-268
- A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age.J Shoulder Elbow Surg. 2014; 23: 1913-1921
- Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: A meta-analysis.AJR Am J Roentgenol. 2009; 192: 1701-1707
- Diagnostic accuracy of ultrasonography for rotator cuff tears: A systematic review and meta-analysis.Orthop J Sports Med. 2021; 923259671211035106
- Diagnostic accuracy of ultrasonography, MRI and MR arthrography in the characterisation of rotator cuff disorders: A systematic review and meta-analysis.Br J Sports Med. 2015; 49: 1316-1328
- Recurrent rotator cuff tear: Is ultrasound imaging reliable?.J Shoulder Elbow Surg. 2018; 27: 1263-1267
- Diagnostic accuracy of ultrasound for rotator cuff tears in adults: A systematic review and meta-analysis.Clin Radiol. 2011; 66: 1036-1048
- Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases.J Bone Joint Surg Am. 2004; 86: 708-716
- Prediction of bilaterality in patients with 1 posterosuperior rotator cuff tear.Am J Sports Med. 2022; 50: 1928-1937
- Degenerative change and rotator cuff tears. An anatomical study in 160 shoulders of 80 cadavers.Arch Orthop Trauma Surg. 1993; 112: 61-64
- Location of rotator cuff tear initiation: A magnetic resonance imaging study of 191 shoulders.Am J Sports Med. 2018; 46: 649-655
- Location and initiation of degenerative rotator cuff tears: An analysis of three hundred and sixty shoulders.J Bone Joint Surg Am. 2010; 92: 1088-1096
- Isolated subscapularis repair in irreparable posterosuperior massive rotator cuff tears involving the subscapularis tendon.Am J Sports Med. 2017; 45: 1269-1275
- Arthroscopic repair of the isolated subscapularis full-thickness tear: Single- versus double-row suture-bridge technique.Am J Sports Med. 2019; 47: 1427-1433
Published online: February 18, 2023
Accepted: February 2, 2023
Received: August 11, 2022
Publication stageIn Press Journal Pre-Proof
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
© 2023 by the Arthroscopy Association of North America