Associations between shoulder symptoms and structural pathology in patients with traumatic rotator cuff injuries

Introduction
The clinical presentation of patients with Rotator Cuff (RC) tears is highly variable and often
numerous concomitant injuries/pathologies are present. The association between concomitant
pathologies and preoperative pain and function has been sparsely evaluated, but could potentially
explain the variable clinical presentation of the patients. The purpose of this study was therefore to
explore the associations between pre-operative shoulder pain and function in patients, clinically and
para-clinically diagnosed with traumatic RC tears and the extent of structural pathology identified
during surgery.
Materials and Methods
Patient reported (PR) function was assessed using the "physical symptoms" domain of the Western
Ontario Rotator Cuff Index (WORC) and shoulder pain was assessed with a 0-10 Numeric Pain
Rating Scale (NPRS) (worst pain last 24 hours). Surgeons recorded the presence of prespecified
structural pathologies including full or partial tears of the rotator cuff, hooked acromion, AC-joint
osteoarthritis, biceps tendon pathology, labral tear, and bone bruise.
Results
Eighty-seven patients were included of which 60% were males and the average age was 60 years
(range 39-79). Seventy-nine percent of the patients had a full-thickness supraspinatus tear, 21% had
a partial-thickness tear. Seventy-nine patients (91%) had concomitant structural pathology. No
association was found between number of structural shoulder pathologies and preoperative PR pain
and function and no particular pathology was associated with worse PR pain or function.
Conclusion
In patients with RC tears, we found no associations between number and type of concomitant
pathologies and PR pain and function.