Paper 167: Vitamin D Level in the Serum Correlates with Fatty Degeneration of Cuff Muscles in Patients with Rotator Cuff Tear

2012 ◽  
Vol 28 (9) ◽  
pp. e433-e434
Author(s):  
Ki Hyun Jo ◽  
Chung Hee Oh ◽  
Hyun Sik Gong ◽  
Sae Hoon Kim ◽  
Joo Han Oh
2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0032
Author(s):  
Sung-Min Rhee ◽  
GunWoo Nam ◽  
Joo Hyun Park ◽  
Hyeon Jang Jeong ◽  
TAE-YON RHIE ◽  
...  

Objectives: To compare the efficacy between the direct effect of nanofiber-based vitamin D sheet engineered with 3D printing (VTD sheet) and vitamin D supplementation (VTDS) as diet on tendon-to-bone healing and muscle regeneration after repair in a chronic rotator cuff tear model of rabbit. Methods: A total of 64 rabbits were randomly allocated into two groups (n=32), then each groups was allocated into four small groups (Group A, A’: VTDS only, Group B, B’: Normal diet + sheet without vitamin D, Group C, C’: Normal diet + VTD sheet, Group D, D’: VTDS + VTD sheet, n=8 each). The supraspinatus tendons which were detached and left for 6 weeks were repaired in a transosseous manner with the sheet only for groups B and B’, and VTD sheet for groups C, C’, D and D’ (Figure 1). Groups A, B, C, and D were extracted at 4weeks after repair, while groups A’, B’, C’, and D’ were extracted at 12 weeks after repair. Serum 25-OH vitamin D level was checked at the time of making tear, repair, and extraction. Regarding tendon-to-bone healing, the expression (relative ratio to control) of genes including type 1 collagen (COL1), type 3 collagen (COL3), bone morphogenic protein-2 (BMP-2), scleraxis (SCX), SOX9, and aggrecan (ACAN) was assessed at 4 weeks (Groups A, B, C, and D), and at 12 weeks (Groups A’, B’, C’, and D’) after repair. The histological and biomechanical evaluations of tendon-to-bone healing were done at 12 weeks after repair. Regarding muscle regeneration, rotator cuff muscle cross-sectional areas were measured at 4 and 12 weeks after repair. Enzyme-linked immunosorbent assay (ELISA) was done to calculate vitamin D level in muscle at 12 weeks after repair. Results: Serum vitamin D level of group D and D’ was highest among groups at the time of repair and extraction (p < 0.001). At 4 weeks after repair, mRNA expression of COL1 in group D was highest among groups (A, B, C, D; 0.86 ± 0.25, 0.90 ± 0.27, 0.93 ± 0.19, and 1.06 ± 0.25, respectively, p = 0.046). At 12 weeks after repair, group D’ showed most dense collagen density (p = 0.037) and had highest load to failure among groups (A’, B’, C’, D’; 102.3 ± 12.6 N, 99.5 ± 8.3 N, 102.3 ± 18.5 N, and 139.6 ± 25.3, respectively, p = 0.024). Regarding muscle regeneration, the cross-sectional area of muscle fiber was largest in group D and D’ at 4 and 12 weeks after repair (p < 0.05, figure 4) with highest vitamin D level of muscle by ELISA at 12 weeks after repair (p = 0.003). Conclusions: The use of nanofiber-based vitamin D sheet engineered with 3D printing may promote tendon-to-bone healing and regenerate rotator cuff muscle after repair in a chronic rabbit rotator cuff tear model.


2021 ◽  
Author(s):  
Atsushi Okubo ◽  
Tadahiko Yotsumoto ◽  
Nobuyoshi Watanabe ◽  
Teruyoshi Kajikawa ◽  
Shun Nakajima ◽  
...  

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.


2014 ◽  
Vol 3 (9) ◽  
pp. 262-272 ◽  
Author(s):  
J. Gumucio ◽  
M. Flood ◽  
J. Harning ◽  
A. Phan ◽  
S. Roche ◽  
...  

2019 ◽  
Vol 22 (3) ◽  
pp. 121-127
Author(s):  
Jung-Han Kim ◽  
Hyeong-Won Seo

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 (<i>p</i><0.001, <i>p</i><0.001, <i>p</i><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.


1970 ◽  
Vol 14 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Joong Bae Seo ◽  
Myung Ho Kim ◽  
Je Min Yi

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.


2014 ◽  
Vol 23 (1) ◽  
pp. 99-108 ◽  
Author(s):  
Jonathan P. Gumucio ◽  
Michael A. Korn ◽  
Anjali L. Saripalli ◽  
Michael D. Flood ◽  
Anthony C. Phan ◽  
...  

2020 ◽  
Vol 23 (3) ◽  
pp. 144-151
Author(s):  
Jung-Han Kim ◽  
Jin-Woo Park ◽  
Si-Young Heo ◽  
Young-Min Noh

Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. Conclusions: This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.


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