TITLE

Relationship of Tear Size and Location to Fatty Degeneration of the Rotator Cuff

AUTHOR(S)
Kim, H. Mike; Dahiya, Nirvikar; Teefey, Sharlene A.; Keener, Jay D.; Galatz, Leesa M.; Yamaguchi, Ken
PUB. DATE
April 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Apr2010, Vol. 92-A Issue 4, p829
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Fatty degeneration of the rotator cuff muscles may have detrimental effects on both anatomical and functional outcomes following shoulder surgery. The purpose of this study was to investigate the relationship between tear geometry and muscle fatty degeneration in shoulders with a deficient rotator cuff. Methods: Ultrasonograms of both shoulders of 262 patients were reviewed to assess the type of rotator cuff tear and fatty degeneration in the supraspinatus and infraspinatus muscles. The 251 shoulders with a full-thickness tear underwent further evaluation for tear size and location. The relationship of tear size and location to fatty degeneration of the supraspinatus and infraspinatus muscles was investigated with use of statistical comparisons and regression models. Results: Fatty degeneration was found almost exclusively in shoulders with a full-thickness rotator cuff tear. Of the 251 shoulders with a full-thickness tear, eighty-seven (34.7%) had fatty degeneration in either the supraspinatus or infraspinatus, or both. Eighty-two (32.7%) of the 251 full-thickness tears had a distance of 0 mm between the biceps tendon and anterior margin of the tear. Ninety percent of the full-thickness tears with fatty degeneration in both muscles had a distance of 0 mm posterior from the biceps, whereas only 9% of those without fatty degeneration had a distance of 0 mm. Tears with fatty degeneration had significantly greater width and length than those without fatty degeneration (p < 0.0001). Tears with fatty degeneration had a significantly shorter distance posterior from the biceps than those without fatty degeneration (p < 0.0001). The distance posterior from the biceps was found to be the most important predictor for supraspinatus fatty degeneration, whereas tear width and length were found to be the most important predictors for infraspinatus fatty degeneration. Conclusions: Fatty degeneration of the rotator cuff muscles is closely associated with tear size and location. The finding of this study suggests that the integrity of the anterior supraspinatus tendon is important to the development of fatty degeneration. Patients with full-thickness tears that extend through this area may benefit from earlier surgical intervention if fatty degeneration has not already occurred. Additionally, the findings suggestthe importance of secure fixation and healing of the anterior aspect of the supraspinatus with surgical repair.
ACCESSION #
49475999

 

Related Articles

  • The effect of multiple channeling on the structural integrity of repaired rotator cuff. Jo, Chris; Yoon, Kang; Lee, Ji; Kang, Seung; Lee, Jae; Han, Hyuk; Rhee, Seung; Shin, Ji // Knee Surgery, Sports Traumatology, Arthroscopy;Dec2011, Vol. 19 Issue 12, p2098 

    Purpose: The purpose of this study was to investigate the effect of adding multiple channeling of the greater tuberosity on the structural integrity of the repaired rotator cuff tendon. Methods: Fifty-six consecutive patients who underwent arthroscopic rotator cuff repair and postoperative...

  • WHAT'S NEW IN SHOULDER AND ELBOW SURGERY. Gartsman, Gary M.; Hasan, Samer S. // Journal of Bone & Joint Surgery, American Volume;Jan2006, Vol. 88-A Issue 1, p230 

    The article presents news related to shoulder and elbow surgery. It informs about changes in supraspinatus tendon composition following tendon detachment and retraction in a rat model. At various time-points following tendon detachment, the rats were killed and the supraspinatus tendons were...

  • Humeral Insertion of the Supraspinatus and Infraspinatus. New Anatomical Findings Regarding the Footprint of the Rotator Cuff. Mochizuki, Tomoyuki; Sugaya, Hiroyuki; Uomizu, Mari; Maeda, Kazuhiko; Matsuki, Keisuke; Sekiya, Ichiro; Muneta, Takeshi; Akita, Keiichi // Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p1 

    BACKGROUND: It is generally believed that the supraspinatus is the most commonly involved tendon in rotator cuff tears. Clinically, however, atrophy of the infraspinatus muscle is frequently observed in patients with even small to medium-size rotator cuff tears. This fact cannot be fully...

  • Development of Fatty Atrophy After Neurologic and Rotator Cuff Injuries in an Animal Model of Rotator Cuff Pathology. Rowshan, Kasra; Hadley, Scott; Pham, Khoa; Caiozzo, Vince; Lee, Thay Q.; Gupta, Ranjan // Journal of Bone & Joint Surgery, American Volume;10/6/2010, Vol. 92-A Issue 13, p2270 

    Background: Detachment of a tendon from its osseous insertion, as can be the case with severe rotator cuff injuries, leads to atrophy of and increased fat in the corresponding muscle. We sought to validate a rotator cuff injury model in the rabbit and to test the hypothesis that tenotomy of a...

  • Tendon quality in small unilateral supraspinatus tendon tears. Real-time sonoelastography correlates with clinical findings. Tudisco, Cosimo; Bisicchia, Salvatore; Stefanini, Matteo; Antonicoli, Marco; Masala, Salvatore; Simonetti, Giovanni // Knee Surgery, Sports Traumatology, Arthroscopy;Feb2015, Vol. 23 Issue 2, p393 

    Purpose: To investigate the feasibility of real-time sonoelastography in the assessment of the mechanical tendon properties in small unilateral supraspinatus tears, to describe the sonoelastographic properties of the torn supraspinatus tendons and to correlate real-time sonoelastography findings...

  • Clinical Outcome After Structural Failure of Rotator Cuff Repairs. Jost, Bernhard; Pfirrmann, Christian W.A.; Gerber, Christian // Journal of Bone & Joint Surgery, American Volume;Mar2000, Vol. 82-A Issue 3, p304 

    Background: The clinical outcome for patients with documented rerupture after open repair of one or more rotator cuff tendons is not well known. The purpose of this study was to evaluate the clinical outcomes of a consecutive series of rotator cuff reruptures after repair and to provide...

  • Isokinetic Muscle Performance Test Can Predict the Status of Rotator Cuff Muscle. Joo Han Oh; Jong Pil Yoon; Jae Yoon Kim; Chung Hee Oh // Clinical Orthopaedics & Related Research;Jun2010, Vol. 468 Issue 6, p1506 

    The isokinetic muscle performance test (IMPT) is a validated and objective method used to evaluate muscle function but it is unknown whether it correlates with severity of rotator cuff tears. We asked whether peak torque and total work deficit on the IMPT correlated with the preoperative manual...

  • Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles. Joo Han Oh; Sae Hoon Kim; Jung-Ah Choi; Yeoju Kim; Chung Hee Oh // Clinical Orthopaedics & Related Research;Jun2010, Vol. 468 Issue 6, p1558 

    Fatty degeneration of the rotator cuff muscles is considered one of the most important factors for the outcomes of cuff repair. However, the reliability of the grading system is not well validated. Two specialists in musculoskeletal radiology and three shoulder fellowship-trained orthopaedic...

  • Arthroscopic Repair of Massive Contracted Rotator Cuff Tears: Aggressive Release with Anterior and Posterior Interval Slides Do Not Improve Cuff Healing and Integrity. Sung-Jae Kim; Sung-Hwan Kim; Su-Keon Lee; Jae-Wan Seo; Yong-Min Chun // Journal of Bone & Joint Surgery, American Volume;8/21/2013, Vol. 95-A Issue 16, p1482 

    Background: Few studies of large-to-massive contracted rotator cuff tears have examined the arthroscopic complete repair obtained by a posterior interval slide and whether the clinical outcomes or structural integrity achieved are better than those after partial repair without the posterior...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics