Exploring multifactorial influences on rotator cuff tear sizes: A comprehensive analysis

Objectives: Rotator cuff tears (RCTs) are among the most common shoulder disorders and affect function and quality of life. The size of the RCTs is classified as small, medium, large, and massive. Risk factors such as advanced age, diabetes, dyslipidemia, and hypertension have been associated with the development of RCTs. However, regional data from Saudi Arabia on the association between these factors and RCT severity remain limited. This study was conducted to address this gap by analyzing the association between RCT size and demographic characteristics. Methods: This retrospective study was conducted at a private hospital on adult patients with RCT who underwent arthroscopic repair by a single surgeon from 2019 to 2023. Dependent variables were analyzed to assess their association with RCT size. Results: A total of 555 patients who underwent arthroscopic rotator cuff repair were included. The mean age was 58 ± 10 years, and females comprised 60% of the cohort. Small tears were the most common (45%), followed by medium (34%), large (13%), and massive tears (8%). Increasing age was independently associated with larger tear sizes ( p < 0.001). Hypertension was associated with larger tear sizes on unadjusted analysis, but did not remain independently associated after adjustment in the multinomial logistic regression model. No significant associations were observed between tear size and sex, affected shoulder, diabetes, dyslipidemia, or biceps tendinitis. Conclusion: These findings highlight the clinical relevance of age as an independent factor associated with RCT severity, while hypertension may serve as a clinical marker associated with larger tear sizes, aiding in clinical risk stratification. Future multicenter studies including larger populations across Saudi Arabia are needed.