Osteoporosis and osteopenia common in rotator cuff tear cohorts

Researchers searched eight databases through May 31, 2026, for studies reporting bone status in people with rotator cuff tears. The systematic review and random-effects meta-analysis included 12 studies and 1,413 participants with categorical bone-status data. Osteoporosis was the primary outcome, with osteopenia and combined abnormal bone mass as secondary or exploratory outcomes. Study quality was assessed using the Joanna Briggs Institute prevalence checklist.

Across 10 studies, 184 of 1,094 participants had osteoporosis; pooled prevalence was 17.3% (95% CI, 13.4%–22.1%; I²=69.0%). A sensitivity analysis using conventional central DXA sites and WHO-compatible criteria found a similar estimate of 17.1% (95% CI, 12.1%–23.6%). Across seven studies, pooled prevalence was 41.9% for osteopenia and 57.9% for combined abnormal bone mass. Heterogeneity was moderate to substantial for these estimates.

The findings describe bone status in the studied rotator cuff tear cohorts but do not show that osteoporosis or osteopenia is more common than in comparable populations: age- and sex-matched comparator data were unavailable. Differences between clinically defined subgroups were not statistically significant (P for interaction=0.083). The authors call for comparative studies using standardized diagnostic criteria.