scholarly journals Shoulder Function and Fatty Infiltration on MRI in Older Adults During Rehabilitation for Rotator Cuff Tear

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Derik Davis ◽  
Ranyah Almardawi ◽  
Omer Awan ◽  
Lawrence Lo ◽  
Sagheer Ahmed ◽  
...  
Keyword(s):  
Older Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Fatty Infiltration ◽  
Shoulder Function ◽  
Control Cohort ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Cohort Groups ◽  
Over Time

Abstract Rotator cuff tear is highly prevalent in older adults, with supraspinatus tendon tear (STT) the most common. Shoulder rehabilitation is a major treatment strategy, but supraspinatus-muscle-fatty infiltration (FI) and shoulder function in older adults with rotator cuff tear primarily managed by physical therapy (PT) is inadequately documented. We tested the hypothesis that older adults receiving usual-care PT when stratified by supraspinatus tear-status differ in supraspinatus FI [by quantitative Dixon fat fraction (FF) and semi-quantitative Goutallier grade (GG) on MRI] and shoulder function [by the American Shoulder and Elbow Surgeons score (ASES-score)] over time. Longitudinal cohort study (pilot): adults 60-85 years, PT-cohort (n=15) and control-cohort (n=25). Participants completed both shoulder MRI and ASES survey at baseline and follow-up visits. Kruskal-Wallis test compared within cohort among 3 groups: no tear (no-STT), partial-thickness tear (pt-STT), full-thickness tear (ft-STT). Mann-Whitney U test compared equivalent groups between cohorts. Baseline PT-cohort groups differed for GG (p=0.033) [no tear, 0.50±0.50;pt-STT, 1.11±0.22;ft-STT, 1.50±0.50] without difference in age, BMI, comorbidity, or ASES-score. Baseline control-cohort groups differed for FF (p=0.034) [no-tear, 5.77%±1.16%;pt-STT, 7.14%±6.26%;ft-STT, 21.44%±10.44%], without difference in age, BMI, comorbidity, or ASES-score. Baseline no-tear groups for ASES-score (p=0.049) differed between cohorts: PT-cohort (58.87±8.21) versus control-cohort (83.98±21.89). Both cohorts showed no difference in Δ-FF or Δ-GG over time. PT-cohort groups differed for Δ-ASES-score over time (p=0.042)[no-tear, 16.65±4.69;pt-STT, -7.24±0.94;ft-STT, 4.48±3.45], but control-cohort groups did not (p>0.050). Our results suggest differences exist for supraspinatus FI and self-reported shoulder function among older adults receiving PT for rotator cuff tear when stratified by supraspinatus tear-status.

Shoulder Strength Requirements for Upper Limb Functional Tasks: Do Age and Rotator Cuff Tear Status Matter?

2017 ◽  
Vol 33 (6) ◽  
pp. 446-452 ◽  
Author(s):  
Anthony C. Santago ◽  
Meghan E. Vidt ◽  
Xiaotong Li ◽  
Christopher J. Tuohy ◽  
Gary G. Poehling ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Upper Limb ◽  
External Rotation ◽  
Strength Loss ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Shoulder Strength

Understanding upper limb strength requirements for daily tasks is imperative for early detection of strength loss that may progress to disability due to age or rotator cuff tear. We quantified shoulder strength requirements for 5 upper limb tasks performed by 3 groups: uninjured young adults and older adults, and older adults with a degenerative supraspinatus tear prior to repair. Musculoskeletal models were developed for each group representing age, sex, and tear-related strength losses. Percentage of available strength used was quantified for the subset of tasks requiring the largest amount of shoulder strength. Significant differences in strength requirements existed across tasks: upward reach 105° required the largest average strength; axilla wash required the largest peak strength. However, there were limited differences across participant groups. Older adults with and without a tear used a larger percentage of their shoulder elevation (p < .001,p < .001) and external rotation (p < .001,p = .017) strength than the young adults, respectively. Presence of a tear significantly increased percentage of internal rotation strength compared to young (p < .001) and uninjured older adults (p = .008). Marked differences in strength demand across tasks indicate the need for evaluating a diversity of functional tasks to effectively detect early strength loss, which may lead to disability.

scholarly journals Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear?

2016 ◽  
Vol 29 ◽  
pp. 90-99 ◽  
Author(s):  
Meghan E. Vidt ◽  
Anthony C. Santago ◽  
Eric J. Hegedus ◽  
Anthony P. Marsh ◽  
Christopher J. Tuohy ◽  
...  
Keyword(s):  
Older Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Self Report ◽  
Cuff Tear ◽  
Functional Differences

Retinoic Acid Receptor Agonists Suppress Muscle Fatty Infiltration in Mice

2021 ◽  
Vol 49 (2) ◽  
pp. 332-339
Author(s):  
Hideyuki Shirasawa ◽  
Noboru Matsumura ◽  
Masaki Yoda ◽  
Kazumasa Okubo ◽  
Masayuki Shimoda ◽  
...  
Keyword(s):  
Gene Expression ◽  
Skeletal Muscle ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Gene Expression Analysis ◽  
Retinoic Acid Receptor ◽  
Adipogenic Differentiation ◽  
Fatty Infiltration ◽  
Cuff Tear

Background: The infiltration of fat tissue into skeletal muscle, a condition referred to as muscle fatty infiltration or fatty degeneration, is regarded as an irreversible event that significantly compromises the motor function of skeletal muscle. Purpose: To investigate the effect of retinoic acid receptor (RAR) agonists in suppressing the adipogenic differentiation of fibroadipogenic progenitors (FAPs) in vitro and fatty infiltration after rotator cuff tear in mice. Study Design: Controlled laboratory study. Methods: FAPs isolated from mouse skeletal muscle were cultured in adipogenic differentiation medium in the presence or absence of an RAR agonist. At the end of cell culture, adipogenic differentiation was evaluated by gene expression analysis and oil red O staining. A mouse model of fatty infiltration—which includes the resection of the rotator cuff, removal of the humeral head, and denervation the supraspinatus muscle—was used to induce fatty infiltration in the supraspinatus muscle. The mice were orally or intramuscularly administered with an RAR agonist after the surgery. Muscle fatty infiltration was evaluated by histology and gene expression analysis. Results: RAR agonists effectively inhibited the adipogenic differentiation of FAPs in vitro. Oral and intramuscular administration of RAR agonists suppressed the development of muscle fatty infiltration in the mice after rotator cuff tear. In accordance, we found a significant decrease in the number of intramuscular fat cells and suppressed expression in adipogenic markers. RAR agonists also increased the expression of the transcripts for collagens; however, an accumulation of collagenous tissues was not histologically evident in the present model. Conclusion: Muscle fatty infiltration can be alleviated by RAR agonists through suppressing the adipogenic differentiation of FAPs. The results also suggest that RAR agonists are potential therapeutic agents for treating patients who are at risk of developing muscle fatty infiltration. The consequence of the increased expression of collagen transcripts by RAR agonists needs to be clarified. Clinical Relevance: RAR agonists can be used to prevent the development of muscle fatty infiltration after rotator cuff tear. Nevertheless, further studies are mandatory in a large animal model to examine the safety and efficacy of intramuscular injection of RAR agonists.

scholarly journals MicroRNA-29a Mitigates Subacromial Bursa Fibrosis in Rotator Cuff Lesion with Shoulder Stiffness

2019 ◽  
Vol 20 (22) ◽  
pp. 5742 ◽  
Author(s):  
Jih-Yang Ko ◽  
Wei-Shiung Lian ◽  
Tsai-Chen Tsai ◽  
Yu-Shan Chen ◽  
Chin-Kuei Hsieh ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Pathological Feature ◽  
Subacromial Bursa ◽  
Shoulder Disorder ◽  
Shoulder Stiffness ◽  
Cuff Tear ◽  
Rotator Cuff Lesion

Rotator cuff lesion with shoulder stiffness is a major cause of shoulder pain and motionlessness. Subacromial bursa fibrosis is a prominent pathological feature of the shoulder disorder. MicroRNA-29a (miR-29a) regulates fibrosis in various tissues; however, the miR-29a action to subacromial bursa fibrosis remains elusive. Here, we reveal that subacromial synovium in patients with rotator cuff tear with shoulder stiffness showed severe fibrosis, hypertrophy, and hyperangiogenesis histopathology along with significant increases in fibrotic matrices collagen (COL) 1A1, 3A1, and 4A1 and inflammatory cytokines, whereas miR-29a expression was downregulated. Supraspinatus and infraspinatus tenotomy-injured shoulders in transgenic mice overexpressing miR-29a showed mild swelling, vascularization, fibrosis, and regular gait profiles as compared to severe rotator cuff damage in wild-type mice. Treatment with miR-29a precursor compromised COL3A1 production and hypervascularization in injured shoulders. In vitro, gain of miR-29a function attenuated COL3A1 expression through binding to the 3’-untranslated region (3′-UTR) of COL3A1 in inflamed tenocytes, whereas silencing miR-29a increased the matrix expression. Taken together, miR-29a loss is correlated with subacromial bursa inflammation and fibrosis in rotator cuff tear with shoulder stiffness. miR-29a repressed subacromial bursa fibrosis through directly targeting COL3A1 mRNA, improving rotator cuff integrity and shoulder function. Collective analysis offers a new insight into the molecular mechanism underlying rotator cuff tear with shoulder stiffness. This study also highlights the remedial potential of miR-29a precursor for alleviating the shoulder disorder.

scholarly journals Evaluation of animal models and methods for assessing shoulder function after rotator cuff tear: A systematic review

2021 ◽  
Vol 26 ◽  
pp. 31-38
Author(s):  
Yang Liu ◽  
Sai C. Fu ◽  
Hio T. Leong ◽  
Samuel Ka-Kin Ling ◽  
Joo H. Oh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Animal Models ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Cuff Tear

Factors Affecting Satisfaction and Shoulder Function in Patients with a Recurrent Rotator Cuff Tear

2014 ◽  
Vol 96 (2) ◽  
pp. 106-112 ◽  
Author(s):  
H Mike Kim ◽  
Jon-Michael E Caldwell ◽  
John A Buza ◽  
Leslie A Fink ◽  
Christopher S Ahmad ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Factors Affecting ◽  
Cuff Tear

Effect of hypercholesterolemia on fatty infiltration and rotator cuff healing in a chronic rotator cuff tear model of rabbit

2016 ◽  
Vol 25 (6) ◽  
pp. e188
Author(s):  
Joo Han Oh ◽  
Seok Won Chung ◽  
HaeBong Park ◽  
Jieun Kwon ◽  
Ghee Young Choe
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Fatty Infiltration ◽  
Cuff Tear

scholarly journals Gene Expression Patterns Analysis in the Supraspinatus Muscle after a Rotator Cuff Tear in a Mouse Model

2018 ◽  
Vol 2018 ◽  
pp. 1-18 ◽  
Author(s):  
Yong-Soo Lee ◽  
Ja-Yeon Kim ◽  
Hyo-Nam Kim ◽  
Dhong-Won Lee ◽  
Seok Won Chung
Keyword(s):  
Gene Expression ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Expression Patterns ◽  
Fatty Infiltration ◽  
Rna Isolation ◽  
Muscle Physiology ◽  
Fatty Acid Transport ◽  
Muscle Degeneration ◽  
Cuff Tear

Rotator cuff tear is a muscle-tendinous injury representative of various musculoskeletal disorders. In general, rotator cuff tear occurs in the tendon, but it causes unloading of the muscle resulting in muscle degeneration including fatty infiltration. These muscle degenerations lead to muscle weakness, pain, and loss of shoulder function and are well known as important factors for poor functional outcome after rotator cuff repair. Given that rotator cuff tear in various animal species results in similar pathological changes seen in humans, the animal model can be considered a good approach to understand the many aspects of the molecular changes in injured muscle. To comprehensively analyze changes in gene expression with time following a rotator cuff tear, we established a rotator cuff tear in mouse supraspinatus tendon of shoulder. At weeks 1 and 4 after the tear, the injured muscles were harvested for RNA isolation, and microarray analysis was performed. Expression patterns of genes belonging to 10 muscle physiology-related categories, including aging, apoptosis, atrophy, and fatty acid transport, were analyzed and further validated using real-time PCR. A total of 39,429 genes were analyzed, and significant changes in expression were observed for 12,178 genes at 1 week and 2,370 genes at 4 weeks after the tear. From the list of top 10 significantly up- and downregulated genes at the 2 time periods and the network evaluation of relevant genes according to the 10 categories, several important genes in each category were observed. In this study, we found that various genes are significantly altered after rotator cuff tear, and these genes may play key roles in controlling muscle degeneration after a rotator cuff tear.

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