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Clin Shoulder Elb > Volume 20(3); 2017 > Article
Clinics in Shoulder and Elbow 2017;20(3):133-137.
DOI:    Published online September 30, 2017.
Serial Magnetic Resonance Imaging to Determine the Progression of Neglected Recalcitrant Rotator Cuff Tears: A Retrospective Multicenter Study
Yon Sik Yoo, Jin Young Park, Chang Hyuk Choi, Nam Su Cho, Chul Hyun Cho, Tae Gang Lim, Sang Don Sim, Tae Yon Rhie, Ho Won Lee, Jong Ho Jung, Yong Beom Lee
1Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
2Global Center for Shoulder, Elbow and Sports at Neon Orthopaedic Clinic, Seoul, Korea.
3Department of Orthopedic Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea.
4Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
5Department of Orthopedic Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
6Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
7Department of Orthopedic Surgery, Donga Hospital, Gwangju, Korea.
8Department of Orthopaedic Surgery, Nalgae Hospital, Seoul, Korea.
9Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
Received: 7 February 2017   • Revised: 15 August 2017   • Accepted: 15 August 2017
BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment.
A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission.
The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group.
We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Key Words: Rotator cuff injury; Steroid; Injection; Intra-articular
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