Sex, BMI, and Sport Determines Shoulder Tear Severity

Male sex, preoperative Western Ontario Shoulder Instability Index score, and type of sport the athletes were playing were associated with large labral tears at the time of the subsequent shoulder instability surgery, according to a new study.

The study, “Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study,” published in the June 2021 issue of Arthroscopy, sought to determine the factors that would predict a large labral tear at the time of shoulder instability surgery.

For the study, the researchers analyzed data on 1,235 patients who were a part of the Multicenter Orthopaedic Outcomes Network Shoulder Instability cohort.

All the patients underwent either open or arthroscopic shoulder instability surgery for a labral tear. Any tear greater than 270˚was defined as large for the purpose of the study.

Overall, there were 22 females (18.0%) and 1,013 males (82.0%) in the study. Their average age was 24.7 years (range 12 to 66).

The prevalence of large tears was 4.6% (n = 57), with the average size of a tear being 141.9˚. Male patients accounted for the majority of the large tears (94/7%; p = .01).

In addition, racquet sports (p = .01), swimming (p = .02), softball (p = .05), skiing (p = .04), and golf (p = .04) were also associated with large labral tears. Patients with a large tear were also more highly likely to have a higher Western Ontario Shoulder Instability Index score (WOSI; p = .01).

“Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (p = 007),” the researchers wrote.