Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: a study of patients with arthroscopically verified cuff tears 22 years ago

Background The prevalence of contralateral full-thickness cuff tears (FTTs) and cuff tear arthropathy (CTA) is presumed to be higher in patients with long-standing cuff tears than in those with newly diagnosed tears, but data are currently lacking. Methods Sixty-one patients with 38 partial and 23 full-thickness tears of 1 shoulder at arthroscopy were examined with bilateral radiographs, ultrasound, and the Constant-Murley score at a mean of 22 years (range, 21-25 years) after arthroscopy. Results The overall rate of full-thickness tears in the contralateral shoulder was 50.8%. In patients with a full-thickness tear and CTA (Hamada grade ≥2) in the index shoulder at follow-up, 18 of 20 (90%) had a contralateral full-thickness tear and 4 of 20 (20%) had CTA. In patients with a partial tear in the index shoulder at follow-up, 3 of 22 (13.6%) had a contralateral full-thickness tear and none had CTA. CTA changes were more common in patients with FTT and a previous acromioplasty ( P  .001). The correlation between shoulders was 0.72 for the number of tendons with FTT ( P  .001), 0.31 for the Hamada grade ( P  = .016), and 0.65 for the absolute Constant-Murley score ( P  .001). The number of tendons with a full-thickness tear at follow-up was a risk factor (odds ratio, 3.28; 95% confidence interval, 1.67-6.44; P  .001) for a contralateral full-thickness tear. Patients with a partial or full-thickness tear in the contralateral shoulder had pain in 39.2% of cases. Conclusion Patients with long-standing cuff tears have high rates of contralateral cuff tears. The severity of the condition is strongly correlated between the shoulders. Patients with full-thickness tears and a previous acromioplasty have a significantly higher frequency of CTA than patients with cuff tears who had not undergone a previous acromioplasty.