What Is the Prevalence of Senior-athlete Rotator Cuff Injuries and Are They Associated With Pain and Dysfunction?
Identifieur interne : 000825 ( Main/Exploration ); précédent : 000824; suivant : 000826What Is the Prevalence of Senior-athlete Rotator Cuff Injuries and Are They Associated With Pain and Dysfunction?
Auteurs : Patrick J. Mcmahon [États-Unis] ; Amitesh Prasad [États-Unis] ; Kimberly A. Francis [États-Unis]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Articulation glénohumérale (imagerie diagnostique), Articulation glénohumérale (physiopathologie), Articulation glénohumérale (traumatismes), Coiffe des rotateurs (imagerie diagnostique), Coiffe des rotateurs (physiopathologie), Douleur (diagnostic), Douleur (physiopathologie), Douleur (épidémiologie), Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Indice de gravité médicale, Lésions de la coiffe des rotateurs, Mesure de la douleur, Mâle, Phénomènes biomécaniques, Prévalence, Sujet âgé, Sujet âgé de 80 ans ou plus, Traumatismes des tendons (imagerie diagnostique), Traumatismes des tendons (physiopathologie), Traumatismes des tendons (épidémiologie), Traumatismes sportifs (imagerie diagnostique), Traumatismes sportifs (physiopathologie), Traumatismes sportifs (épidémiologie), Échographie, Évaluation de l'incapacité.
- MESH :
- diagnostic : Douleur.
- imagerie diagnostique : Articulation glénohumérale, Coiffe des rotateurs, Traumatismes des tendons, Traumatismes sportifs.
- physiopathologie : Articulation glénohumérale, Coiffe des rotateurs, Douleur, Traumatismes des tendons, Traumatismes sportifs.
- traumatismes : Articulation glénohumérale.
- épidémiologie : Douleur, Traumatismes des tendons, Traumatismes sportifs.
- Adulte d'âge moyen, Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Indice de gravité médicale, Lésions de la coiffe des rotateurs, Mesure de la douleur, Mâle, Phénomènes biomécaniques, Prévalence, Sujet âgé, Sujet âgé de 80 ans ou plus, Échographie, Évaluation de l'incapacité.
English descriptors
- KwdEn :
- Age Factors, Aged, Aged, 80 and over, Athletic Injuries (diagnostic imaging), Athletic Injuries (epidemiology), Athletic Injuries (physiopathology), Biomechanical Phenomena, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain (diagnosis), Pain (epidemiology), Pain (physiopathology), Pain Measurement, Prevalence, Risk Factors, Rotator Cuff (diagnostic imaging), Rotator Cuff (physiopathology), Rotator Cuff Injuries, Severity of Illness Index, Shoulder Joint (diagnostic imaging), Shoulder Joint (injuries), Shoulder Joint (physiopathology), Tendon Injuries (diagnostic imaging), Tendon Injuries (epidemiology), Tendon Injuries (physiopathology), Ultrasonography.
- MESH :
- diagnosis : Pain.
- diagnostic imaging : Athletic Injuries, Rotator Cuff, Shoulder Joint, Tendon Injuries.
- epidemiology : Athletic Injuries, Pain, Tendon Injuries.
- injuries : Shoulder Joint.
- physiopathology : Athletic Injuries, Pain, Rotator Cuff, Shoulder Joint, Tendon Injuries.
- Age Factors, Aged, Aged, 80 and over, Biomechanical Phenomena, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain Measurement, Prevalence, Risk Factors, Rotator Cuff Injuries, Severity of Illness Index, Ultrasonography.
Abstract
Older individuals with rotator cuff injuries may have difficulties not only with activities of daily living, but also with sports activities.
(1) How frequent and severe are rotator cuff abnormalities, as identified by ultrasound, in senior athletes? (2) To what degree does the severity of ultrasound-identified rotator cuff pathology correlate with pain and shoulder dysfunction?
We assessed pain and shoulder function in 141 elite athletes older than 60 years of age (median age, 70 years; range 60–84) at the Senior Olympics who volunteered to participate. An ultrasound evaluation of the rotator cuff of the dominant shoulder was performed by an experienced musculoskeletal radiologist in all of these elite athletes. We then determined the relationship between ultrasound findings and shoulder pain and shoulder function as assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeons (ASES) scores.
There were 20 shoulders with a normal cuff (14.2% [20 of 141], of which 5% [one of 20] were painful), 23 with tendinosis (16.3% [23 of 141], of which 30% [six of 20] were painful), 68 with a partial-thickness rotator cuff tear (48.2% [68 of 141], of which 32% [20 of 63] were painful), and 30 with a full-thickness rotator cuff tear (21.3% [30 of 141], of which 25% [seven of 28] were painful). Only 5% of athletes (one of 20) with a normal cuff on ultrasound evaluation reported shoulder pain, whereas 30% of athletes (33 of 111) with any degree of rotator cuff damage on ultrasound evaluation reported shoulder pain, This resulted in an odds ratio of 8.0 (95% confidence interval, 1.0–62.5). The proportion of patients who had pain was not different in those with different severities of rotator cuff pathology. Neither the ASES nor the DASH was different in those with different severities.
The frequency of full-thickness rotator cuff tears in senior athletes was 21.3% (30 of 141). Pain was a predictor of rotator cuff injury but not of its severity. The odds of having shoulder pain was eight times greater in those athletes with any rotator cuff damage as compared with those without any rotator cuff damage. Those with pain had poorer shoulder function but the ASES and DASH were poor predictors of the severity of rotator cuff pathology. Rotator cuff tears in older individuals are often not painful and may not need to be repaired for successful participation in athletics.
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Url:
DOI: 10.1007/s11999-014-3560-7
PubMed: 24619795
PubMed Central: 4079892
Affiliations:
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Athletic Injuries (diagnostic imaging)</term>
<term>Athletic Injuries (epidemiology)</term>
<term>Athletic Injuries (physiopathology)</term>
<term>Biomechanical Phenomena</term>
<term>Disability Evaluation</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pain (diagnosis)</term>
<term>Pain (epidemiology)</term>
<term>Pain (physiopathology)</term>
<term>Pain Measurement</term>
<term>Prevalence</term>
<term>Risk Factors</term>
<term>Rotator Cuff (diagnostic imaging)</term>
<term>Rotator Cuff (physiopathology)</term>
<term>Rotator Cuff Injuries</term>
<term>Severity of Illness Index</term>
<term>Shoulder Joint (diagnostic imaging)</term>
<term>Shoulder Joint (injuries)</term>
<term>Shoulder Joint (physiopathology)</term>
<term>Tendon Injuries (diagnostic imaging)</term>
<term>Tendon Injuries (epidemiology)</term>
<term>Tendon Injuries (physiopathology)</term>
<term>Ultrasonography</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Articulation glénohumérale (imagerie diagnostique)</term>
<term>Articulation glénohumérale (physiopathologie)</term>
<term>Articulation glénohumérale (traumatismes)</term>
<term>Coiffe des rotateurs (imagerie diagnostique)</term>
<term>Coiffe des rotateurs (physiopathologie)</term>
<term>Douleur (diagnostic)</term>
<term>Douleur (physiopathologie)</term>
<term>Douleur (épidémiologie)</term>
<term>Facteurs de l'âge</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Lésions de la coiffe des rotateurs</term>
<term>Mesure de la douleur</term>
<term>Mâle</term>
<term>Phénomènes biomécaniques</term>
<term>Prévalence</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Traumatismes des tendons (imagerie diagnostique)</term>
<term>Traumatismes des tendons (physiopathologie)</term>
<term>Traumatismes des tendons (épidémiologie)</term>
<term>Traumatismes sportifs (imagerie diagnostique)</term>
<term>Traumatismes sportifs (physiopathologie)</term>
<term>Traumatismes sportifs (épidémiologie)</term>
<term>Échographie</term>
<term>Évaluation de l'incapacité</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Pain</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Douleur</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Athletic Injuries</term>
<term>Rotator Cuff</term>
<term>Shoulder Joint</term>
<term>Tendon Injuries</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Athletic Injuries</term>
<term>Pain</term>
<term>Tendon Injuries</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Articulation glénohumérale</term>
<term>Coiffe des rotateurs</term>
<term>Traumatismes des tendons</term>
<term>Traumatismes sportifs</term>
</keywords>
<keywords scheme="MESH" qualifier="injuries" xml:lang="en"><term>Shoulder Joint</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Articulation glénohumérale</term>
<term>Coiffe des rotateurs</term>
<term>Douleur</term>
<term>Traumatismes des tendons</term>
<term>Traumatismes sportifs</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Athletic Injuries</term>
<term>Pain</term>
<term>Rotator Cuff</term>
<term>Shoulder Joint</term>
<term>Tendon Injuries</term>
</keywords>
<keywords scheme="MESH" qualifier="traumatismes" xml:lang="fr"><term>Articulation glénohumérale</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Douleur</term>
<term>Traumatismes des tendons</term>
<term>Traumatismes sportifs</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Biomechanical Phenomena</term>
<term>Disability Evaluation</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pain Measurement</term>
<term>Prevalence</term>
<term>Risk Factors</term>
<term>Rotator Cuff Injuries</term>
<term>Severity of Illness Index</term>
<term>Ultrasonography</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Facteurs de l'âge</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Lésions de la coiffe des rotateurs</term>
<term>Mesure de la douleur</term>
<term>Mâle</term>
<term>Phénomènes biomécaniques</term>
<term>Prévalence</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Échographie</term>
<term>Évaluation de l'incapacité</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Older individuals with rotator cuff injuries may have difficulties not only with activities of daily living, but also with sports activities.</p>
</sec>
<sec><title>Questions/purposes</title>
<p>(1) How frequent and severe are rotator cuff abnormalities, as identified by ultrasound, in senior athletes? (2) To what degree does the severity of ultrasound-identified rotator cuff pathology correlate with pain and shoulder dysfunction?</p>
</sec>
<sec><title>Methods</title>
<p>We assessed pain and shoulder function in 141 elite athletes older than 60 years of age (median age, 70 years; range 60–84) at the Senior Olympics who volunteered to participate. An ultrasound evaluation of the rotator cuff of the dominant shoulder was performed by an experienced musculoskeletal radiologist in all of these elite athletes. We then determined the relationship between ultrasound findings and shoulder pain and shoulder function as assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeons (ASES) scores.</p>
</sec>
<sec><title>Results</title>
<p>There were 20 shoulders with a normal cuff (14.2% [20 of 141], of which 5% [one of 20] were painful), 23 with tendinosis (16.3% [23 of 141], of which 30% [six of 20] were painful), 68 with a partial-thickness rotator cuff tear (48.2% [68 of 141], of which 32% [20 of 63] were painful), and 30 with a full-thickness rotator cuff tear (21.3% [30 of 141], of which 25% [seven of 28] were painful). Only 5% of athletes (one of 20) with a normal cuff on ultrasound evaluation reported shoulder pain, whereas 30% of athletes (33 of 111) with any degree of rotator cuff damage on ultrasound evaluation reported shoulder pain, This resulted in an odds ratio of 8.0 (95% confidence interval, 1.0–62.5). The proportion of patients who had pain was not different in those with different severities of rotator cuff pathology. Neither the ASES nor the DASH was different in those with different severities.</p>
</sec>
<sec><title>Conclusions</title>
<p>The frequency of full-thickness rotator cuff tears in senior athletes was 21.3% (30 of 141). Pain was a predictor of rotator cuff injury but not of its severity. The odds of having shoulder pain was eight times greater in those athletes with any rotator cuff damage as compared with those without any rotator cuff damage. Those with pain had poorer shoulder function but the ASES and DASH were poor predictors of the severity of rotator cuff pathology. Rotator cuff tears in older individuals are often not painful and may not need to be repaired for successful participation in athletics.</p>
</sec>
<sec><title>Level of Evidence</title>
<p>Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.</p>
</sec>
</div>
</front>
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<region><li>Pennsylvanie</li>
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<name sortKey="Mcmahon, Patrick J" sort="Mcmahon, Patrick J" uniqKey="Mcmahon P" first="Patrick J." last="Mcmahon">Patrick J. Mcmahon</name>
<name sortKey="Prasad, Amitesh" sort="Prasad, Amitesh" uniqKey="Prasad A" first="Amitesh" last="Prasad">Amitesh Prasad</name>
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