Correlation between the incidence of rotator cuff lesion in traumatic unilateral anterior glenohumeral dislocation and the contralateral shoulder

F Alfano; D Á Moya; D J Gómez

doi:10.1016/j.recot.2022.11.005

Correlation between the incidence of rotator cuff lesion in traumatic unilateral anterior glenohumeral dislocation and the contralateral shoulder

Rev Esp Cir Ortop Traumatol. 2023 Jul-Aug;67(4):271-278. doi: 10.1016/j.recot.2022.11.005. Epub 2022 Nov 30.

[Article in English, Spanish]

Authors

F Alfano¹, D Á Moya², D J Gómez²

Affiliations

¹ Hospital Privado Gipuzkoa Asunción Klinika, Tolosa, Gipuzkoa, España. Electronic address: drfedericoalfano@gmail.com.
² Hospital Británico de Buenos Aires, Buenos Aires, Argentina.

PMID: 36462725
DOI: 10.1016/j.recot.2022.11.005

Abstract

Introduction: Anterior glenohumeral dislocation in patients older than 60 years is related to rotator cuff lesion because of its pre-existing degenerative condition. However, in this age group, the scientific evidence fails to elucidate whether rotator cuff lesions are the cause or consequence of recurrent shoulder instability. The objective of this paper is to describe the prevalence of rotator cuff injuries in a series of consecutive shoulders in patients older than 60 years who suffered a first episode of traumatic glenohumeral dislocation, and its correlation with rotator cuff injuries in both shoulders.

Methods: Retrospectively, 35 patients over 60 years of age who had a first episode of unilateral traumatic anterior glenohumeral dislocation and who had MRI of both shoulders were studied, evaluating both shoulders with MRI to determine the structural damage correlation of the rotator cuff and long head of the biceps between them.

Results: When assessing the existence of partial or complete injury to the supraspinatus and infraspinatus tendons, the concordance on the affected and healthy sides, we have shown concordant results on both sides in 88.6 and 85.7%, respectively. The Kappa concordance coefficient was 0.72 for supraspinatus and infraspinatus tendons tear. Of the total of 35 cases evaluated, 8 (22.8%) presented at least some alteration in the tendon of the long head of the biceps on the affected side and only one (2.9%) on the healthy side, where the Kappa coefficient of concordance was 0.18. Of the 35 cases evaluated, 9 (25.7%) presented at least some retraction in the tendon of the subscapularis muscle on the affected side, while no participant showed signs of retraction in the tendon of this muscle on the healthy side.

Conclusions: Our study has found a high correlation of the presence of a postero-superior rotator cuff injury after presenting a glenohumeral dislocation between the shoulder that has suffered the event and the presumably healthy contralateral shoulder. Nevertheless, we have not found this same correlation with subscapularis tendon injury and medial biceps dislocation.

Keywords: Glenohumeral dislocation; Glenohumeral instability; Inestabilidad glenohumeral; Luxación glenohumeral; Manguito rotador; Rotator cuff; Supraespinoso; Supraspinatus.