Risk factors for rotator cuff tear in Syrian adults: a cross-sectional study

Rotator cuff tears (RCTs) are a common shoulder condition, particularly prevalent among older individuals, even though there is limited data regarding the risk factors associated with RCT patients. This research aimed to analyze factors impact on the RCT among the Syrian population. This cross-sectional study utilized a self-administered questionnaire to gather detailed information about RCT and their individual and physical characteristics across eight orthopedic and rehabilitation centers in four provinces of Syria: Damascus, Aleppo, Homs, and Latakia. This data collection occurred from October 2021 to November 2022, with two centers chosen from each province. We assessed participants' background factors, conducted physical examinations, and performed ultrasonographic evaluations on both shoulders. The study included 236 participants (totaling 472 shoulders), comprising 107 males and 129 females (P = 0.04), with an average age of 58.5 years. Among those presenting with current symptoms, 41.2% were diagnosed with rotator cuff tears (RCT), while 58.7% did not exhibit these tears (P = 0.02). Additionally, 26.3% of asymptomatic individuals were found to have RCT, with 73.7% showing no signs of these tears (P = 0.004). Rotator cuff tears were primarily associated with advanced age, male gender, involvement of the dominant arm, engagement in heavy labor, a history of trauma, a positive impingement sign, reduced active forward elevation, and decreased muscle strength in the abduction and external rotation. Logistic regression analysis identified a history of trauma, the dominance of the affected arm, and age as significant risk factors for the occurrence of RCT. The odds ratios for a history of trauma were 2.74 (95% CI 2.36-2.92); for the dominant arm, it was 2.25 (95% CI 2.10-2.68), and for age, it was 1.76 (95% CI 1.82-2.04). This study identifies key risk factors for RCT in Syrian patients, including trauma history, arm dominance, and age. It highlights the interplay of internal and external factors in symptomatic and asymptomatic tears, with diagnostic indicators like positive impingement signs aiding early detection and management.