Risk Factors Impacting the Onset and Progression of Rotator Cuff Tears in the Syrian Population: A Longitudinal Observational Study

Background

Rotator cuff tears (RCTs) are a common shoulder disorder, yet longitudinal data on risk factors for their onset and progression remain limited. This study aimed to identify factors influencing RCT development and progression in a Syrian population over a 5-year period.

Methods

A longitudinal observational study was conducted with 222 shoulders from 146 participants assessed in 2018 and 2023. Data included demographics, pain patterns (Visual Analog Scale > 35), range of motion (ROM), Simple Shoulder Test scores, radiographic osteoarthritic changes (Samilson-Prieto classification), and ultrasonographic RCT severity. Statistical analyses compared groups with/without RCT at baseline and evaluated progression risks using logistic regression.

Results

At baseline (2018), 76 shoulders had RCT, while 146 were intact. By 2023, 32 of the intact shoulders developed RCT, with Samilson-Prieto grade 2 osteoarthritic changes as the primary risk factor (OR = 5.87, 95% CI: 1.86–22.06). Among shoulders with baseline RCT, 43.4% (33/76) showed progression, predicted by pain during motion (OR = 8.53, 95% CI: 3.73–37.41). ROM declined and osteoarthritis advanced in all groups, regardless of RCT status.

Conclusion

Moderate osteoarthritic changes (S-P grade 2) independently predicted new RCT onset, while pain during motion signaled progression of existing tears. These findings highlight distinct risk factors for RCT development and progression, informing clinical monitoring strategies.