Shoulder Instability in Patients Over 40 Years Old: Is Concomitant Rotator Cuff Tear Determinant for Shoulder Function and Quality of Life?

Abstract Background: The Western Ontario Rotator Cuff (WORC) index is a self-report questionnaire that measures the disease-specific quality of life in patients with rotator cuff injuries. The aim of this study was to evaluate the psychometric properties of the Taiwanese version of WORC (T-WORC) in patients with rotator cuff tear (RCT) before surgery. Methods: A cross-sectional study design was used. The study was composed of two phases: translation of the WORC into Taiwanese version of WORC, and 210 patients with rotator cuff tear before surgery completed the questionnaire twice within 2 weeks. The main outcome measures included reliability and validity. Reliability was assessed with internal consistency and test-retest. Internal consistency was assessed using the Cronbach’s alpha and test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Construct validity was evaluated by examining convergent, divergent, known-group validity, and exploratory factor analysis (EFA). Results: The T-WORC demonstrated satisfactory reliability with the Cronbach's alpha of .94, and ICC (2 week-interval) of .79. The convergent validity showed that the T-WORC was significantly positively correlated with the disability of the arm, shoulder, and hand and numerical rating scales of pain, but negatively correlated with the Short Form-12. The divergent validity was shown by the low correlation between T-WORC and state anger scale. The known-group validity showed a significant difference between the high pain group and the low pain group. The EFA revealed 4 factors, daily activities and function, physical symptoms, emotion, and shoulder clicking and recreation, which explained 66.13 % of the variance. Conclusions: The findings of this study did not support the 5-domain structure proposed by the original version. Nevertheless, the T-WORC still demonstrated adequate psychometric properties and could be a useful instrument for assessing the RCT patients' quality of life before surgery.

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The impact of full-thickness rotator cuff tear on shoulder function and quality of life in patients who sustain a proximal humerus fracture. A prospective cohort study

JSES International ◽

10.1016/j.jseint.2021.11.003 ◽

2021 ◽

Author(s):

Helle K. Østergaard ◽

Antti P. Launonen ◽

Bakir O. Sumrein ◽

Marianne T. Vestermark ◽

Juha Paloneva ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Rotator Cuff ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Shoulder Function ◽

Full Thickness ◽

Cuff Tear ◽

The Impact

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Evaluate the Results at Minimum 2-Years of Treating Rotator Cuff Tear by Arthroscopic Surgery

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.358 ◽

2019 ◽

Vol 7 (24) ◽

pp. 4199-4203

Author(s):

Dung Tran Trung ◽

Duc Nguyen Anh ◽

Tuan Tran Duc ◽

Van Nguyen Trung ◽

Thien Chu Dinh

Keyword(s):

Quality Of Life ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Arthroscopic Surgery ◽

University Hospital ◽

Rotator Cuff Tears ◽

Average Score ◽

Cuff Tear

BACKGROUND: Rotator cuff tear (RCT) is a common injury of the shoulder, especially middle-aged people. Nonoperative treatment, cortisone injections are only effective at an early stage. Open surgery causes postoperative atrophy of the deltoid muscle, so results are limited. Arthroscopic rotator cuff repair surgery has been performed in Vietnam for about ten years, with many advantages such as the ability to accurately assess the lesions and less invasive procedure. In order to have a clearer view, we performed a mid-term assessment of the effectiveness of this surgery. AIM: Evaluate results over 2 years of patients with rotator cuff tears treated with arthroscopic surgery and their quality of life. METHOD: A group of 30 patients were diagnosed with RCT and surgery by arthroscopy to treat at Hanoi Medical University Hospital and Saint Paul Hospital between Jun 2015 and April 2017. The results of the surgeries were assessed by the degree of pain, muscle power, motion of the shoulder joint according to UCLA shoulder score. Evaluate the quality of life through the Rotator Cuff-Quality of Life (RC-QoL) index. RESULTS: The average age was 60.7 years. Female / male ratio was 1.3. Thirty-six months ± 6.41 was the average follow-up time (min 27 – max 50 months). The shoulder function is recorded according to UCLA has an average score of 30.9, therein good and excellent result were 90 %. The mean RC-QoL index was 91.5%. CONCLUSION: Treatment of RCT by arthroscopic surgery that has been evaluated for a minimum of 2 years follow-up showed good results and high quality of patient’s life.

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MicroRNA-29a Mitigates Subacromial Bursa Fibrosis in Rotator Cuff Lesion with Shoulder Stiffness

International Journal of Molecular Sciences ◽

10.3390/ijms20225742 ◽

2019 ◽

Vol 20 (22) ◽

pp. 5742 ◽

Cited By ~ 1

Author(s):

Jih-Yang Ko ◽

Wei-Shiung Lian ◽

Tsai-Chen Tsai ◽

Yu-Shan Chen ◽

Chin-Kuei Hsieh ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Function ◽

Pathological Feature ◽

Subacromial Bursa ◽

Shoulder Disorder ◽

Shoulder Stiffness ◽

Cuff Tear ◽

Rotator Cuff Lesion

Rotator cuff lesion with shoulder stiffness is a major cause of shoulder pain and motionlessness. Subacromial bursa fibrosis is a prominent pathological feature of the shoulder disorder. MicroRNA-29a (miR-29a) regulates fibrosis in various tissues; however, the miR-29a action to subacromial bursa fibrosis remains elusive. Here, we reveal that subacromial synovium in patients with rotator cuff tear with shoulder stiffness showed severe fibrosis, hypertrophy, and hyperangiogenesis histopathology along with significant increases in fibrotic matrices collagen (COL) 1A1, 3A1, and 4A1 and inflammatory cytokines, whereas miR-29a expression was downregulated. Supraspinatus and infraspinatus tenotomy-injured shoulders in transgenic mice overexpressing miR-29a showed mild swelling, vascularization, fibrosis, and regular gait profiles as compared to severe rotator cuff damage in wild-type mice. Treatment with miR-29a precursor compromised COL3A1 production and hypervascularization in injured shoulders. In vitro, gain of miR-29a function attenuated COL3A1 expression through binding to the 3’-untranslated region (3′-UTR) of COL3A1 in inflamed tenocytes, whereas silencing miR-29a increased the matrix expression. Taken together, miR-29a loss is correlated with subacromial bursa inflammation and fibrosis in rotator cuff tear with shoulder stiffness. miR-29a repressed subacromial bursa fibrosis through directly targeting COL3A1 mRNA, improving rotator cuff integrity and shoulder function. Collective analysis offers a new insight into the molecular mechanism underlying rotator cuff tear with shoulder stiffness. This study also highlights the remedial potential of miR-29a precursor for alleviating the shoulder disorder.

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Evaluation of animal models and methods for assessing shoulder function after rotator cuff tear: A systematic review

Journal of Orthopaedic Translation ◽

10.1016/j.jot.2020.02.012 ◽

2021 ◽

Vol 26 ◽

pp. 31-38

Author(s):

Yang Liu ◽

Sai C. Fu ◽

Hio T. Leong ◽

Samuel Ka-Kin Ling ◽

Joo H. Oh ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Animal Models ◽

Rotator Cuff Tear ◽

Shoulder Function ◽

Cuff Tear

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The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear

Disability and Rehabilitation ◽

10.3109/09638288.2012.670363 ◽

2012 ◽

Vol 34 (24) ◽

pp. 2071-2075 ◽

Cited By ~ 21

Author(s):

Kirsi Piitulainen ◽

Jari Ylinen ◽

Hannu Kautiainen ◽

Arja Häkkinen

Keyword(s):

Quality Of Life ◽

Rotator Cuff ◽

Functional Disability ◽

Health Related Quality ◽

Disability And Health ◽

Cuff Tear ◽

Related Quality ◽

Health Related ◽

The Relationship

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Analysis of glenohumeral morphological factors for anterior shoulder instability and rotator cuff tear by magnetic resonance imaging

Journal of Orthopaedic Surgery ◽

10.1177/2309499018768100 ◽

2018 ◽

Vol 26 (2) ◽

pp. 230949901876810 ◽

Cited By ~ 2

Author(s):

B Saygi ◽

N Karahan ◽

O Karakus ◽

AI Demir ◽

OC Ozkan ◽

...

Keyword(s):

Magnetic Resonance ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Instability ◽

Normal Population ◽

Anterior Shoulder Instability ◽

Glenoid Version ◽

Glenohumeral Instability ◽

Cuff Tear ◽

Coronal Height

Objective: The aim of this study was to investigate whether there are glenohumeral morphological differences between normal population, glenohumeral instability, and rotator cuff pathology. Method: In this study, shoulder magnetic resonance (MR) images of 150 patients were evaluated. Patients included in the study were studied in three groups of 50 individuals: patients with anterior shoulder instability in group 1, patients with rotator cuff tear in group 2, and control subjects without shoulder pathology in group 3. Results: There were statistically significant differences between groups in evaluations for glenoid version, glenoid coronal height, glenoid coronal diameter, humeral axial and coronal diameters, and coracohumeral interval distances. Significant differences were observed between groups 2 and 3 in glenoid axial diameter, glenoid coronal height, glenoid depth, humeral coronal diameter, and coracohumeral distances. Conclusion: The results obtained in this study suggest that glenoid version, glenoid coronal height and diameter, humeral diameter, and coracohumeral interval parameters in glenohumeral morphology-related parameters in patients with anterior instability are different from those of normal population and patients with rotator cuff pathology. In cases where there is a clinically difficult diagnosis, these radiological measurements will be helpful to clinicians in diagnosis and treatment planning, especially in cases of treatment-resistant cases.

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