Rotator cuff disease, or trauma to the rotator cuff, is a common complaint and can be caused by an injury, overuse whether due to sporting endeavour or employment, or can occur without any obvious cause.
A new study has helped to identify risk factors that increase the need for shoulder surgery as a result of rotator cuff disease. The population-based cohort study is one of the largest of its kind. Here, we’ll look at what it revealed, and you’ll discover more about rotator cuff injuries.
Understanding the new study
The recent large-scale study included data from 421,894 patients, with 47% being male. Participants were aged between 40-69 and the UK’s Biobank was used for the research. NHS inpatient records were used to identify patients who had undergone surgery for rotator cuff disease.
Hazard ratios were calculated using Multivariate Cox proportional hazards regression. The main risk factors discovered were sex, age, race, BMI, smoking, occupational demands and the Townsend deprivation index.
Interestingly, the study found that every additional 10 years of age contributed to a 55% increase in surgery rates for rotator cuff disease. A high BMI, non-white races and a lower deprivation score also contributed to an increased risk of surgery.
The majority of the risks identified are known to be modifiable. This means the risks can be reduced through healthier lifestyle choices.
The link between depression and rotator cuff tears
Although this new study is one of the largest of its kind, there have been previous smaller studies carried out that are worth referencing. In 2019, a study looked into the link between depression and rotator cuff tears and it produced some surprising results.
Depressive disorders are known to be associated with chronic systemic inflammation. Depression, for example, is associated with chronic diseases such as coronary artery disease and chronic obstructive pulmonary disease. So, how does this link to rotator cuff tears?
Although the underlying mechanism of how depression is associated with rotator cuff tears remains uncertain, it’s thought that inflammation not only plays a role in the onset of tendon injury but also then negatively impacts repair of injured tendons. Furthermore, depression could heighten the sensation of pain associated with rotator cuff disease in those patients suffering from depression.
Further research is needed to determine exactly how the two conditions are associated. However, the evidence so far does support they are connected. Patients with depression are more likely to require surgery for a rotator cuff tear than those without the mental health condition.
What is a rotator cuff tear?
The rotator cuff of the shoulder consists of numerous muscles and tendons which cushion the shoulder joint. It is responsible for keeping the upper arm bone within the shoulder socket. A tear can occur in any of the muscles or tendons surrounding the joint.
Usually, rotator cuff tears are caused by overuse or repetitive motions. However, they can occur as a single injury. They vary in severity and in some cases, surgery may be the only way to repair the injury.
While surgery can be an effective solution to the pain and lack of mobility associated with a rotator cuff tear, there are always risks associated with surgery that need to be considered. The new study suggests that healthier lifestyle choices may reduce the need for surgery. If you suspect you have rotator cuff disease, call 0203 195 2442 to arrange a consultation with the London Shoulder Specialists.