scholarly journals Partial-thickness Rotator Cuff Tear Itself Did Not Cause Shoulder Pain Or Muscle Weakness In Baseball Players

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0043
Author(s):  
Teruhisa Mihata ◽  
Rei Morikura ◽  
Kunimoto Fukunishi ◽  
Yukitaka Fujisawa ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Shoulder Pain ◽  
Muscle Weakness ◽  
Return To Play ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Baseball Players ◽  
Partial Thickness ◽  
Significant Difference

Objectives: Rotator cuff tears are common shoulder injuries in baseball players. In some severe tears (i.e. through more than 50% of the cuff’s thickness), conservative treatment does not work well, and surgical treatment is sometimes chosen in an effort to ensure return to play. In contrast, some partial thickness rotator cuff tears do not cause shoulder symptoms, even during throwing motion. The objective of this study was to assess whether partial thickness rotator cuff tears cause shoulder pain and muscle weakness in baseball players. Methods: We studied 87 university baseball players (age: 19.5±0.8 years; baseball career: 11.5±1.6 years). Rotator cuff tendons were ultrasonographically examined (Fig 1), then divided into 4 groups; (1) no tear, (2) supraspinatus tendon tear, (3) infraspinatus tendon tear, (4) both supraspinatus and infraspinatus tendons tear. Current shoulder pain and shoulder muscle strength (Dominant/Non-dominant) in abduction, external rotation, and internal rotation were compared using Chi square test and t-test. Results: Forty-one (47%) players were diagnosed with articular-sided partial-thickness rotator cuff tears using ultrasonography. Nineteen tears were in the supraspinatus, 13 in the infraspinatus, and 9 in both the supraspinatus and the infraspinatus. Tear depth was 4.6±2.3 mm in the supraspinatus and 6.2±3.6 mm in the infraspinatus. There was no significant difference in rate of shoulder pain (p=0.96) and muscle strength among four groups (p=0.15 - 0.70). Conclusion: In this study, articular-sided partial-thickness rotator cuff tears did not cause shoulder pain and muscle weakness in university baseball players. Most of articular-sided partial-thickness rotator cuff tears are tears of the superior capsule but not the rotator cuff tendons, because the superior capsule is attached in the articular half of the greater tuberosity. Therefore, most so-called articular-sided partial-thickness rotator cuff tears may not be pathological tendon tear.

Partial-Thickness Rotator Cuff Tear by Itself Does Not Cause Shoulder Pain or Muscle Weakness in Baseball Players

2019 ◽  
Vol 47 (14) ◽  
pp. 3476-3482
Author(s):  
Teruhisa Mihata ◽  
Rei Morikura ◽  
Akihiko Hasegawa ◽  
Kunimoto Fukunishi ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Muscle Weakness ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Baseball Players ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Tendon Tears

Background: Partial-thickness rotator cuff tears are common shoulder injuries in baseball players. For some tears, the symptoms can be relieved through physical therapy or debridement without rotator cuff repair. Purpose: To assess whether partial-thickness rotator cuff tear by itself causes shoulder pain and muscle weakness in baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We studied 87 university baseball players (age, 19.5 ± 0.8 years; baseball career, 11.5 ± 1.6 years). All data were obtained during a full-participation annual medical check in 1 team. Rotator cuff tendons were examined ultrasonographically and allocated to 4 groups: (1) no tear, (2) supraspinatus tendon tear, (3) infraspinatus tendon tear, and (4) both supraspinatus and infraspinatus tendon tears. Current shoulder pain and shoulder muscle strength (dominant/nondominant) in abduction, external rotation, and internal rotation were compared by using chi-square and t tests. All players could play baseball with or without shoulder pain in this study. Results: Of the 87 players, 41 (47%) had articular-sided partial-thickness rotator cuff tears diagnosed on ultrasonography; the remaining 46 athletes were tear-free. Of the 41 affected patients, 19 had tears in the supraspinatus, 13 in the infraspinatus, and 9 in both the supraspinatus and infraspinatus tendons. Tear depth (mean ± SD) was 4.6 ± 2.3 mm in the supraspinatus and 6.2 ± 3.6 mm in the infraspinatus. Neither the rate of shoulder pain nor muscle strength differed significantly among the 4 groups ( P = .96 and P = .15-.70, respectively). Conclusion: Articular-sided partial-thickness rotator cuff tear—by itself—did not cause shoulder pain and muscle weakness in university baseball players. Most so-called articular-sided partial-thickness rotator cuff tears may not be pathologic tendon tears.

scholarly journals Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Surgical Correction ◽  
Statistical Testing ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Linear Probe ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

scholarly journals ROLE AND CORELATION OF ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN EVALUATION OF ROTATOR CUFF IN PATIENTS WITH SHOULDER PAIN

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Niti More ◽  
R P Bansal ◽  
Mukesh Kumar Sharma ◽  
Bijendra Kumar Meena ◽  
Abhishek Gupta
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Age Groups ◽  
Rotator Cuff Tears ◽  
Joint Effusion ◽  
Full Thickness ◽  
Mri Findings ◽  
Partial Thickness ◽  
Labral Tears ◽  
Sensitivity Specificity

Background: Shoulder pain is one of the most common musculoskeletal complain encountered in general practice with an estimated point prevalence of 6.9 to 26% in the general population. The aim of the study was to determine the accuracy of ultrasonography in detecting rotator cuff tears taking MRI findings as the standard. Available literature related to the present study was reviewed and salient features of each pathology discussed. Methods: This observational, prospective study was carried out in the Department of Radiodiagnosis, National Institute Of Medical Sciences & Research, Jaipur, Rajasthan. A total of 80 patients from all age groups with symptomatology related to rotator cuff of the shoulder joint, on the basis of inclusion criteria, were examined by USG and MRI from a period of January 2019 to June 2020. Results: USG had good sensitivity (82 to 93%), specificity (92 to 97%), PPV (85 to 87%), NPV (91 to 98%) and accuracy (90 to 96%) as compared MRI for diagnosing supraspinatus lesions. The sensitivity and accuracy of USG for detecting full thickness tears was better than the same for partial thickness tears and tendinosis. Conclusion: In our study, USG examination had excellent sensitivity, specificity and accuracy as compared MRI for diagnosing full thickness rotator cuff tears. It was also fairly accurate in detecting partial thickness tears and tendinosis. It was comparable to MRI in diagnosing and quantifying joint effusion and acromioclavicular degenerative changes. USG scored over MRI in diagnosing calcific tendinosis while some findings, such as labral tears, were only detected by MRI. Keywords: MRI, USG, Shoulder pain.

scholarly journals Partial-thickness rotator cuff tears in university baseball players

2016 ◽  
Vol 6 ◽  
pp. 53
Author(s):  
Rei Morikura ◽  
Teruhisa Mihata ◽  
Yasuo Itami ◽  
Akihiko Hasegawa ◽  
Masashi Neo
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Baseball Players ◽  
Partial Thickness

scholarly journals Arthroscopic Repair of Articular Surface Partial-Thickness Rotator Cuff Tears: Transtendon Technique versus Repair after Completion of the Tear—A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yohei Ono ◽  
Jarret M. Woodmass ◽  
Aaron J. Bois ◽  
Richard S. Boorman ◽  
Gail M. Thornton ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Articular Surface ◽  
Constant Score ◽  
Surgical Techniques ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Long Term Outcome ◽  
Partial Thickness ◽  
Significant Difference

Articular surface partial-thickness rotator cuff tears (PTRCTs) are commonly repaired using two different surgical techniques: transtendon repair or repair after completion of the tear. Although a number of studies have demonstrated excellent clinical outcomes, it is unclear which technique may provide superior clinical outcomes and tendon healing. The purpose was to evaluate and compare the clinical outcomes following arthroscopic repair of articular surface PTRCT using a transtendon technique or completion of the tear. A systematic review of the literature was performed following PRISMA guidelines and checklist. The objective outcome measures evaluated in this study were the Constant Score, American Shoulder and Elbow Surgeons score, Visual Analogue Scale, physical examination, and complications. Three studies met our criteria. All were prospective randomized comparative studies with level II evidence and published from 2012 to 2013. A total of 182 shoulders (mean age 53.7 years; mean follow-up 40.5 months) were analyzed as part of this study. Both procedures provided excellent clinical outcomes with no significant difference in Constant Score and other measures between the procedures. Both procedures demonstrated improved clinical outcomes. However, there were no significant differences between each technique. Further studies are required to determine the long-term outcome of each technique.

Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears: Comparison of Clinical Outcomes With and Without Subscapularis Tear

2020 ◽  
Vol 48 (14) ◽  
pp. 3429-3438
Author(s):  
Teruhisa Mihata ◽  
Thay Q. Lee ◽  
Akihiko Hasegawa ◽  
Kunimoto Fukunishi ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Clinical Outcomes ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Tendon Tear ◽  
Subscapularis Tear ◽  
Subscapularis Tendon Tear ◽  
Group 3 ◽  
Group 2

Background: Arthroscopic superior capsule reconstruction (SCR) was developed to restore shoulder superior stability, muscle balance, and function in patients with irreparable posterior-superior rotator cuff tears. Purpose: To assess the effects of concomitant subscapularis tendon tear, which may reduce glenohumeral stability and force coupling, on clinical outcomes of SCR for irreparable posterior-superior rotator cuff tears. Study Design: Cohort study; Level of evidence, 3. Methods: In total, 193 patients with irreparable posterior-superior rotator cuff tears underwent arthroscopic SCR using fascia lata autograft between 2007 and 2015. They were allocated to 3 groups: group 1, no subscapularis tear (160 patients); group 2, reparable subscapularis tear, which underwent arthroscopic repair (26 patients); and group 3, irreparable subscapularis tear (7 patients). American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS) score for pain, active shoulder range of motion (ROM), muscle strength (manual muscle test), and acromiohumeral distance were evaluated before surgery and at final follow-up (mean, 3 years, 7 months; range, 2-11 years). Postoperative complications were assessed. Results: In groups 1 and 2, ASES, JOA, and VAS scores and shoulder ROM and muscle strength improved significantly after SCR with subscapularis repair ( P < .001). SCR in group 3 significantly improved ASES, JOA, and VAS scores ( P < .001), whereas shoulder ROM and muscle strength did not increase significantly. Postoperative acromiohumeral distance was significantly smaller in group 3 (5.7 ± 2.9 mm [mean ± SD]) than group 2 (9.1 ± 2.3 mm) ( P = .002). Group 3 had a significantly higher rate of graft tear ( P < .001) and postoperative infection ( P < .001) than group 1. Conclusion: The presence of subscapularis tendon tear affects clinical outcomes and complication rates after SCR. The reparability of the subscapularis affects superior glenohumeral stability; therefore, an intact subscapularis or reparable subscapularis tendon tear is the best indication for arthroscopic SCR in patients with irreparable posterior-superior rotator cuff tendon tears.

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