Risk factors for full-thickness rotator cuff tears: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational (cohort and cross-sectional) studies
PubMed 34909227 · doi:10.1302/2058-5241.6.210027
What was done
A systematic review and meta-analysis of cohort and cross-sectional studies retrieved from PubMed, Embase, and Web of Science published before January 30, 2021. The authors investigated risk factors for full-thickness rotator cuff tears using RevMan 5.3 to calculate relative risks (RRs) or weighted mean differences (WMDs/MDs), and Stata 15.1 to evaluate publication bias.
What was found
The review included 11 articles from six countries with 4,047 participants (1,518 cases and 2,529 controls). Statistically significant risk factors were age (MD = 0.76, 95% CI: 0.24 to 1.28, P = 0.004), hypertension (RR = 1.46, 95% CI: 1.17 to 1.81, P = 0.0007), and critical shoulder angle (MD = 2.02, 95% CI: 1.55 to 2.48, P < 0.00001). Body mass index, sex, dominant hand, smoking, diabetes mellitus, and thyroid disease were not significantly associated with full-thickness tears.
Why it matters
This study clarifies which patient-specific and anatomical factors correlate with full-thickness rotator cuff tears, highlighting hypertension and critical shoulder angle alongside age as potential diagnostic targets.
Limits
All included sources were observational (cohort and cross-sectional studies), which precludes causal inference. The abstract does not report heterogeneity measures (I² values), exact numerical results or effect sizes for non-significant factors, or adjustment for confounding variables across the pooled studies.
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