Asymptomatic Rotator Cuff Tears Among the Indian Population: Prevalence, Risk Factors, and Tear Characteristics.

Background: Rotator cuff tears (RCTs) are common among the middle-aged and elderly, but frequently remain asymptomatic. The purpose of this study was to evaluate the prevalence of asymptomatic full and partial-thickness RCTs in the Indian population, and to assess their association with potential risk factors for their development. Methods: In all, 284 asymptomatic shoulders in 150 Indian patients (74.6% male, mean age 58.6 ± 9.3 years) over the age of 40 years who presented with non-shoulder-related complaints between March 2018 and March 2019 were studied. Their medical history, and physical and ultrasonographic examination findings were noted. The prevalence and characteristics of RCTs were assessed. The association between RCTs and potential risk factors for their occurrence (increasing age, sex, hand dominance, repetitive overhead activity, and a history of smoking, diabetes mellitus, and thyroid disorders) was assessed. Results: A prevalence of 10.6% (95% CI 7.0%-14.1%), 10.9% (95% CI 7.3%-14.5%), and 21.1% (16.4%-25.9%) was noted for full-thickness RCTs, partial-thickness RCTs, and RCTs overall. Supraspinatus tears were the most common. Partial width and articular side tears were most prevalent among full and partial-thickness RCTs, respectively. Full-thickness tears were more prevalent among the elderly and those with a history of repetitive overhead activity. A statistically significant but clinically negligible deterioration of range of movement and clinical scores was noted among patients with asymptomatic RCTs. Conclusion: Asymptomatic RCTs are common among Indians above the age of 40 years. Future research can investigate the reasons for development of symptoms and disability, and the benefits of early detection of RCTs.