Effect of tamoxifen on fatty degeneration and atrophy of rotator cuff muscles in chronic rotator cuff tear: An animal model study

Abstract Background: Rotator cuff tear with delamination is considered as a risk factor for postoperative retear after rotator cuff repair. The purpose of this study was to compare clinical outcomes between 3 repair procedures for large or massive rotator cuff tears with delamination: conventional en masse suture bridge (EMSB), double-layer suture bridge (DLSB), and combination of double-layer suture bridge and modified Debyere-Patte (DLSB+DP) methods.Methods: A total of 53 shoulders of 52 patients who had large or massive rotator cuff tears with delamination were included. The patients were categorized into 3 groups: EMSB group comprised 18 patients, DLSB group comprised 24 shoulders of 23 patients, and DLSB+DP group comprised 11 patients. DP was applied for cases in which the rotator cuff was unable to be covered up to the footprint even though it was sufficiently mobilized. The mean postoperative follow-up period was 34.6 months (range, 24-72 months). Pre- and postoperative evaluations included the Constant scores and range of motion (ROM). Tendon integrity according to Sugaya classification, and fatty degeneration were also evaluated by magnetic resonance images (MRI).Results: The ROM significantly improved after the operation in all groups. Mean constant scores significantly improved (from 45.5±14.3 to 77.4±13.6, in the EMSB, from 45.5±11.6 to 87.6±11.4 in the DLSB, and from 46.3±11.2 to , and 88.0±10.5 in the DLSB+DP). Significant differences were noted in the postoperative Constant score (p<0.05: DLSB vs. EMSB , and p<0.05: DLSB+DP vs. EMSB)． The Constant pain score was better in the DLSB+DP than in the EMSB group. The mean pre-operative global fatty degeneration index was 1.52 in the EMSB group, 1.80 in the DLSB group, and 2.28 in the DLSB+DP group. Retear occurred in 27.8% in the EMSB group, 12.5% in the DLSB group, and 9.1% in the DLSB+DP group. Conclusions: Comparison of 3 groups demonstrated that DLSB and DLSB+DP achieved better clinical outcome than EMSB. DLSB+DP is useful for large or massive rotator cuff tears with severe fatty degeneration or for cases where presence of excessive tension is anticipated when repairing the torn cuff.

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Outcome of Arthroscopic Suture Bridge Technique for Rotator Cuff Tear: Short Term Clinical Outcome In Full-thickness Tear With Fatty Degeneration Less Than Moderate Degree

Clinics in Shoulder and Elbow ◽

10.5397/cise.2009.12.2.180 ◽

2009 ◽

Vol 12 (2) ◽

pp. 180-188 ◽

Cited By ~ 1

Author(s):

Sang-Jin Cheon ◽

Joon-Oh Hur ◽

Jeung-Tak Suh ◽

Chong-Il Yoo

Keyword(s):

Rotator Cuff ◽

Clinical Outcome ◽

Rotator Cuff Tear ◽

Fatty Degeneration ◽

Moderate Degree ◽

Full Thickness ◽

Short Term ◽

Suture Bridge ◽

Cuff Tear ◽

Suture Bridge Technique

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T lymphocytes are not required for the development of fatty degeneration after rotator cuff tear

Bone and Joint Research ◽

10.1302/2046-3758.39.2000294 ◽

2014 ◽

Vol 3 (9) ◽

pp. 262-272 ◽

Cited By ~ 7

Author(s):

J. Gumucio ◽

M. Flood ◽

J. Harning ◽

A. Phan ◽

S. Roche ◽

...

Keyword(s):

Rotator Cuff ◽

T Lymphocytes ◽

Rotator Cuff Tear ◽

Fatty Degeneration ◽

Cuff Tear

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Relationship of Posterior Decentering of the Humeral Head with Tear Size and Fatty Degeneration in Rotator Cuff Tear

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.22.3.121 ◽

2019 ◽

Vol 22 (3) ◽

pp. 121-127

Author(s):

Jung-Han Kim ◽

Hyeong-Won Seo

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Humeral Head ◽

Fatty Degeneration ◽

Subscapularis Tendon ◽

Tendon Tear ◽

Level Of Evidence ◽

Cuff Tear ◽

Subscapularis Tendon Tear ◽

Tear Size

Background: Posterior decentering is not an uncommon finding on rotator cuff tear patients’ shoulder magnetic resonance imaging. No previous study has reported on the relationship between posterior decentering and rotator cuff tear.Methods: We assessed patients’ rotator cuff tear humeral head positions based on humeral?scapular alignment (HSA). Subjects were classified into centering and decentering groups based on a <2 mm or >2 mm HSA value, respectively. Differences in rotator cuff tear size, degree of tear, and fatty degeneration between the two groups were evaluated.Results: One hundred seventy-five patients (80 males, 95 females; mean age: 59.7 ± 6.5 years old) were selected as subjects (casecontrol study; level of evidence: 3). Tear size, degree of subscapularis tendon tear, and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis muscles were significantly different between the two groups (p<0.001, p<0.001, p<0.001).Conclusions: The occurrence of decentering was related to rotator cuff tear size, degree of subscapularis tendon tear, and fatty degeneration of the rotator cuff muscles.

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Relationship of the Sagittal Extent of Rotator Cuff Tears to the Grade of Fatty Degeneration of the Rotator Cuff Muscles

Clinics in Shoulder and Elbow ◽

10.5397/cise.2011.14.2.159 ◽

1970 ◽

Vol 14 (2) ◽

pp. 159-164 ◽

Cited By ~ 1

Author(s):

Joong Bae Seo ◽

Myung Ho Kim ◽

Je Min Yi

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Fatty Degeneration ◽

Rotator Cuff Tears ◽

Cuff Tear ◽

Anteroposterior Diameter ◽

Shoulder Mri ◽

Group 5 ◽

Group 2 ◽

Tear Size

PURPOSE: To investigate the relationship between the size of a rotator cuff tear and the grade of fatty degeneration of the supraspinatus and infraspinatus muscles.MATERIALS AND METHODS: From a database of 541 patients who underwent a shoulder MRI between September 2004 and September 2010, we enrolled 148 patients that had a full-thickness rotator cuff tear. The anteroposterior diameter of the tear was measured in sagittal views on an MRI. The patients were divided into 6 groups reflecting the anteroposterior diameter: group 1 (a width of <10 mm), group 2 (10 mm< or =width<15 mm), group 3 (15 mm< or =width<20 mm), group 4 (20 mm< or =width<25 mm), group 5 (25 mm< or =width<30 mm) and group 6 (a width<30 mm). Fatty degeneration was rated according to Goutallier et al.RESULTS: Fatty degeneration in the supraspinatus and infraspinatus muscles increased with the severity of the rotator cuff tear. The supraspinatus fatty degeneration increased prominently as the tear size increased from 15~19 mm to 20~24 mm and from 25~29 mm to over 30 mm. The infraspinatus fatty degeneration increased prominently as the tear size increased from 25~29 mm to over 30 mm. Seventeen patients had tear widths under 10 mm and 8 patients among them had fatty degeneration of the infraspinatus.CONCLUSION: Fatty degeneration in supraspinatus and infraspinatus muscles increases prominently at specific tear sizes. The presence of tears under 10 mm with infraspinatus fatty degeneration indicates that the infraspinatus tendon may have an anatomical or functional effect even in small tears.

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