Abstract
To the Editor,
Recently, we read with the article by Kanatlı et al. 1 We agree with the authors that the presence of reverse flap capsule tear was associated with bursal-sided partial rotator cuff tears. In this study, the authors stated that sensitivity and specificity of the presence of reverse flap capsular tear as a sign of bursal-sided partial rotator cuff tears were 87.5% and 61.8%, respectively. Although it has a higher sensitivity, but the specificity of the reverse flap capsule tear was not high for diagnosis of partial rotator cuff tears. This may be associated with insufficient samples, patient selection bias, and inappropriate control group. In fact, medical history, careful physical examination, and detailed imaging are more helpful to further distinguish the partial-thickness rotator cuff tears and other lesions.
Previous study showed that the patients with partial-thickness articular surface rotator cuff tears had a significantly increased frequency of associated synovitis and bicep tendon degeneration (fraying or tearing) and a documented injury. 2 In this study, concomitant intra-articular pathology was found in 40 (80%) of 50 patients with bursal-sided tears and the most frequently observed concomitant intra-articular pathology was found to be capsule tears with a rate of 54%. The complex anatomy of the shoulder can create difficulties in distinguishing symptoms that occur with different pathologies. 3 For appropriate treatment planning, it is important to reveal whether the symptoms are clinically associated with those pathologies (such as capsule tears). The impact of concomitant intra-articular pathologies on clinical outcome should also be assessed in the postoperative follow-up. We think these findings are of value for clinicians in decision-making in the future.
It should also be noted that there were some mistakes in the article. In Table 3, the panel described the p value “0.009” should be “0.09” as authors described in paragraph 4 in the “Discussion section.” The description of Figure 4 was also inaccurate. In Figure 4(a), the diagram means full thickness tears, rather than partial bursal-sided rotator cuff tear.
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by Shenzhen Second People’s Hospital Clinical Research Project (20193357019).
