Abstract
BackgroundUse of the arm above shoulder level has been described as a risk factor for developing rotator cuff tears (RCT). There is a lack of information regarding the frequency and distribution of RCT in a population using their arms above shoulder level during daily work. The aim of this study was to analyze clinical and radiographic findings in a population of painters working more than 10 years and to compare the results with a control group (CG)Materials and methods100 individuals working more than 10 years as a painter were compared to 100 matched controls without using their arms above shoulder level. MRI scans were performed in all participants. Clinically, the Constant score, DASH score and range of motion (ROM) of the shoulders were analyzed.ResultsIn the painter group (PG) a tear of the supraspinatus tendon was detected in 45% (10%full-thickness; 35% partial) compared to 8% in the (CG) (3% full-thickness; 5%partial; p<0.001). Impingement test was painful in 52% of PG and 7% of CG (p<0.001). The Constant score in the PG was significantly lower compared to the CG (62 vs. 93 points; p<0.001). PG had significantly worse DASH scores and inferior active and passive ROM of the dominant shoulders. In the multivariable logistic regression analysis, three risk factors (smoking, sports activity, and handedness) showed no effect. However, group membership (PG/CG) and age revealed a significant effect.ConclusionLong-term occupational load on the shoulders in painters seems to be associated with an increased risk for developing RCT. Our findings may provide support for developing preventive strategies for this unique cohort.Level of evidence: III
Highlights
Rotator cuff tears (RCT) of the shoulder are tendon injuries that, from the sixth decade of life onward, are associated relatively often with degenerative changes and are less frequently the result of trauma.Symptoms of chronic RCT are pain, weakness, and a restricted range of motion [1]
Use of the arm above shoulder level has been described as a risk factor for developing rotator cuff tears (RCT)
There is a lack of information regarding the frequency and distribution of RCT in a population using their arms above shoulder level during daily work
Summary
Rotator cuff tears (RCT) of the shoulder are tendon injuries that, from the sixth decade of life onward, are associated relatively often with degenerative changes and are less frequently the result of trauma.Symptoms of chronic RCT are pain, weakness, and a restricted range of motion [1]. Rotator cuff tears (RCT) of the shoulder are tendon injuries that, from the sixth decade of life onward, are associated relatively often with degenerative changes and are less frequently the result of trauma. It is postulated that working with the arm held at and above shoulder level causes impingement, with compression of the supraspinatus tendon under thecoraco-acromial arch, potentially leading to tendon injury through mechanical wear and ischemia [9,10,11,12]. Use of the arm above shoulder level has been described as a risk factor for developing rotator cuff tears (RCT). There is a lack of information regarding the frequency and distribution of RCT in a population using their arms above shoulder level during daily work. The aim of this study was to analyze clinical and radiographic findings in a population of painters working more than 10 years and to compare the results with a control group (CG)
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