Abstract

BackgroundChronic inflammation is known to be associated with both rotator cuff tears (RCTs) and depression. However, no epidemiological studies with a longitudinal follow-up have been performed to prove this association. We aimed to investigate whether depressed patients had an elevated risk of RCT and subsequent repair surgery compared with those without depression.MethodsThis retrospective cohort study comprised of patients diagnosed with depression between 2000 and 2010 (depression cohort) and patients without depression (non-depression cohort, 1:2 age and sex matched). The risk of RCT and rotator cuff repair surgery were determined during a 13-year follow-up (2000–2013) between these two cohorts.ResultsThis study included 26,868 patients with depression and 53,736 patients without depression. The incidence of RCT was 648 and 438 per 100,000 person-years in the depression and non-depression cohorts, respectively. The adjusted hazard ratio (HR) was 1.46 (95% confidence interval [CI], 1.36–1.57) for depressed patients. The incidence of rotator cuff repair surgery was 28 and 18 per 100,000 person-years in the depression and non-depression cohorts, respectively. Depressed patients also had a significantly increased risk of subsequent rotator cuff repair surgery (adjusted HR = 1.46; 95% CI, 1.04–2.06).ConclusionThe present study showed that depression was associated with an increased risk of rotator cuff tear and rotator cuff repair surgery.

Highlights

  • Depressive disorders have been recognized as being associated with chronic systemic inflammation [1,2]

  • The risk of rotator cuff tears (RCTs) and rotator cuff repair surgery were determined during a 13-year follow-up (2000–2013) between these two cohorts

  • Depressed patients had a significantly increased risk of subsequent rotator cuff repair surgery

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Summary

Introduction

Depressive disorders have been recognized as being associated with chronic systemic inflammation [1,2]. Rotator cuff tear (RCT) is a common disease associated with shoulder pain and functional disability, including shoulder motion limitation and weakness [13]. Chronic inflammation contributes to a variety of age-associated diseases [17], and a number of previous studies have demonstrated its involvement in each step of tendon injury [18,19,20]. Chronic inflammation is known to be associated with both rotator cuff tears (RCTs) and depression. We aimed to investigate whether depressed patients had an elevated risk of RCT and subsequent repair surgery compared with those without depression

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