Fatty Degeneration of the Rotator Cuff Reflects Shoulder Strength Deficits in Patients With Rotator Cuff Tears

Orthopedics ◽  
2017 ◽  
Vol 41 (1) ◽  
pp. e15-e21 ◽  
Author(s):  
Jong Pil Yoon ◽  
Jae Wook Jung ◽  
Chang Hwa Lee ◽  
Young Gun Kim ◽  
Seok Won Chung ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Shoulder Strength

scholarly journals Rotátorköpeny-szakadás után kialakult zsíros degeneráció változása az ín rekonstrukcióját követően, 65 éves kor után

2019 ◽  
Vol 160 (14) ◽  
pp. 533-539
Author(s):  
Imre Sallai ◽  
Márton Weidl ◽  
Attila Szatmári ◽  
Imre Antal ◽  
Gábor Skaliczki
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Fatty Degeneration ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Before And After ◽  
Cuff Repair

Abstract: Introduction: In the case of rotator cuff tears, the severity of the muscle atrophy and fatty degeneration has an effect on the success of the repair and on the functional outcome after surgery. Aim: The ability of regeneration reduces with ageing; therefore, the study examined the atrophy and the fatty degeneration after rotator cuff repair in patients over 65. Method: Eleven patients over 65 years of age were involved whose surgery was performed at the Department of Orthopaedics of Semmelweis University between 2012 and 2015. Their average age was 71.9 years and the average follow-up period was 39.9 months. Tear sizes were C1 in 3 cases, C2 in 3 cases, C3 in 4 cases, and C4 in 1 case. Each patient had magnetic resonance examination before and after the repair; the muscle atrophy and fatty degeneration were evaluated together with the type of the tear. Visual analogue scale and Constant score were used for the assessment of the pain and the shoulder function. Results: The average Constant score was 75 points. The occupancy ratio – referring to the severity of the atrophy – did not show significant improvement. The change in fatty degeneration and the atrophy were examined in different groups according to the size of the tears. In each group, the results showed progression. Conclusions: After rotator cuff repair in patients over 65, fatty degeneration and muscle atrophy also show progression. No significant relationship was found between the size of the tear and fatty degeneration or between the size of the tear and muscle atrophy. Orv Hetil. 2019; 160(14): 533–539.

Correlation Between Age and Tendon Strength in Supraspinatus Tendon With Full-Thickness Tears

2013 ◽  
Author(s):  
R. Matthew Miller ◽  
Daisuke Araki ◽  
Yoshimasa Fujimaki ◽  
Volker Musahl ◽  
Richard E. Debski
Keyword(s):  
Rotator Cuff ◽  
Treatment Outcomes ◽  
Clinical Problem ◽  
Supraspinatus Tendon ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Insufficient Information ◽  
Poor Treatment ◽  
The Relationship

Degenerative tears of the rotator cuff tendons are a significant clinical problem, with an incidence of more than 30% in asymptomatic persons over the age of 60 [1]. As the population continues to age, the incidence of partial and full-thickness rotator cuff tears continues to increase [2], with previous studies finding that greater age also correlates with worse surgical outcomes and increased fatty degeneration in the tissue [3]. Although the relationship between age, rotator cuff injury, and poor treatment outcomes has been previously established, insufficient information exists on the biological and mechanical changes in the tissue due to aging.

Shoulder Strength With Rotator Cuff Tears

1993 ◽  
Vol &NA; (288) ◽  
pp. 174???178 ◽  
Author(s):  
DAVID KIRSCHENBAUM ◽  
MICHAEL P. COYLE ◽  
JOSEPH P. LEDDY ◽  
POLIXENI KATSAROS ◽  
FERNANDO TAN ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Shoulder Strength

The prospective evaluation of changes in fatty infiltration and shoulder strength in nonsurgically treated rotator cuff tears

2017 ◽  
Vol 22 (4) ◽  
pp. 676-681 ◽  
Author(s):  
Yoshihiro Nakamura ◽  
Shin Yokoya ◽  
Yohei Harada ◽  
Katsunori Shiraishi ◽  
Nobuo Adachi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Fatty Infiltration ◽  
Rotator Cuff Tears ◽  
Prospective Evaluation ◽  
Shoulder Strength

Hybrid Technology Fusion MRI/US and Sonoelastography in Diagnosis of Fatty Degeneration and Atrophy of Supraspinatus Muscle of the Shoulder

2017 ◽  
pp. 112-123
Author(s):  
V. E. Gazhonova ◽  
M. V. Emelianenko ◽  
M. P. Onishchenko
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Diagnostic Performance ◽  
Interobserver Reliability ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Point Scale ◽  
Supraspinatus Muscle ◽  
Us Elastography

Evaluation of the rotator cuff muscles is of value for surgical indications and successful postoperative prognosis. Ultrasound is  widely used for detection of rotator cuff tears, but it’s role in  evaluation of the rotator cuff muscles is not yet defined. A new  method Fusion MRI/US with elastography is able to show differences  in tissue stiffness, and a simultaneous combination of two methods  helps to overcome limitations from US – narrow field of view, and  from MRI – impossibility for real time examination and low space resolution.Purpose.To investigate diagnostic performance and interobserver  reliability of US elastography and to study possibilities of Fusion  MRI/US technique in grading fatty degeneration and atrophy of the supraspinatus muscle.Materials and methods.72 patients from 128 with shoulder pain  and disability with written diagnostic confirm were specially selected  for the study with US elastography and MRI and 29 patients were  enrolled for Fusion MRI/US study. Oblique sagittal scans through the  supraspinatus muscle were performed during US elastography study  in the standard manner for comparance with MRI. The amount of  fatty degeneration was graded according to the modified Goutallier five-point scale, with use of a 3-point scale – with US elastography.  US results for grade of atrophy and fatty degeneration were  retrospectively reviewed by 2 blinded to each other results experts.  Sensitivity and interobserver reliability was estimated.Results.The sensitivity of standard US in comparance to US  elastography in assessment of muscle atrophy with the reference to  MRI was 53% and 76%, respectively. The sensitivity of US and US  elastography increased with increasing of the grade of muscle  atrophy. The sensitivity of US and US elastography in detection of  fatty degeneration was slightly better 65% and 85%, respectively.  US elastography were more sensitive in evaluation of fatty  degeneration in full thickness than in partial thickness rotator cuff tears. In all cases of full thickness tears US with elastography had a 100% sensitivity in assessment of atrophy and fatty degeneration in the reference to MRI. While in partial tears  the sensitivity decreased to 66%. The agreement between MRI and US elastography for the grade of fatty degeneration of the  supraspinatus was substantial (kappa = 0.78). The interobserver  reliability for US was fair (kappa = 0.41), and for US elastography  substantial (kappa=0,71).Conclusion. Sonoelastography helps to increase the diagnostic  performance of US in identifying and grading fatty degeneration and  atrophy of the supraspinatus. US with elastography can be used as a  primary modality for fatty changes and atrophy of the supraspinatus.

Irreparable Large to Massive Rotator Cuff Tears With Low-Grade Fatty Degeneration of the Infraspinatus Tendon: Minimum 7-Year Follow-up of Fascia Autograft Patch Procedure and Partial Repair

2021 ◽  
pp. 036354652110435
Author(s):  
Daisuke Mori ◽  
Kazuha Kizaki ◽  
Noboru Funakoshi ◽  
Fumiharu Yamashita ◽  
Yasuyuki Mizuno ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Low Grade ◽  
Partial Repair ◽  
Massive Rotator Cuff Tears ◽  
Infraspinatus Tendon

Background: In shoulders with irreparable massive rotator cuff tears (RCTs) with high-grade fatty degeneration (Goutallier stage 3 or 4) of the supraspinatus tendon and low-grade fatty degeneration (Goutallier stage 1 or 2) of the infraspinatus tendon (ISP), arthroscopic patch grafting (PG) has been reported as superior to partial repair (PR) regarding the ISP retear rate at short-term to midterm follow-up. However, the longer term outcomes are unclear. Purpose: To compare clinical and structural outcomes in the PG and PR groups at a minimum of 7 years postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 24 patients in the PG group and 24 patients in the PR group. We primarily used the Constant score for clinical outcomes and performed magnetic resonance imaging for structural outcomes in the PG and PR groups. The risk factors for a retear of the ISP were identified by univariate and multivariate (forward stepwise selection method) logistic regression analyses. We primarily compared values at midterm follow-up (<4 years) with values at the final follow-up (minimum 7 years) for each patient. Results: The mean midterm and final follow-up times for the PG group were 41.0 and 95.1 months, respectively, compared with 35.7 and 99.3 months, respectively, for the PR group. We found significant differences for the midterm and final follow-up Constant total scores in the PG and PR groups (midterm follow-up: 79.1 vs 69.9, respectively [ P = .001]; final follow-up: 76.0 vs 65.3, respectively [ P = .006]) and in the Constant strength scores (midterm follow-up: 14.6 vs 8.5, respectively [ P < .001]; final follow-up: 13.1 vs 8.3, respectively [ P = .001]). Treatment group (PR) was a significant predictor of an ISP retear in the logistic regression analysis (odds ratio, 3.545; P = .043). Conclusion: Patients with low-grade massive RCTs treated with PG or PR improved significantly in terms of clinical outcomes at the midterm and final follow-up time points. However, Constant scores were significantly better in the PG group at the final follow-up.

PDGFRα+ PDGFRß+ Progenitor Cells Contribute to Fatty Degeneration and Fibrosis Following Massive Rotator Cuff Tears in a Murine Model

2018 ◽  
Vol 27 (4) ◽  
pp. e137-e138
Author(s):  
Andrew R. Jensen ◽  
Benjamin V. Kelley ◽  
Gina Mosich ◽  
Allison Ariniello ◽  
Brandon K. Vu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Progenitor Cells ◽  
Murine Model ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears

Effect of Acromioplasty on Postoperative Pain Following Rotator Cuff Repair

2021 ◽  
pp. 155633162199312
Author(s):  
Chintanpreet Singh ◽  
Patrick H. Lam ◽  
George A. C. Murrell
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcome ◽  
Additional Benefit ◽  
Rotator Cuff Tears ◽  
Shoulder Stiffness ◽  
Patient Reported ◽  
Shoulder Strength ◽  
Pain At Rest ◽  
Cuff Repair

Background: The surgical treatment of rotator cuff tears traditionally involves rotator cuff repair (RCR) with concomitant acromioplasty. However, there is some doubt as to whether acromioplasty is of value to this procedure. Questions/Purpose: We sought to evaluate whether RCR with acromioplasty provided better outcomes than RCR without acromioplasty in a cohort of more than 1000 patients. Methods: This retrospective cohort study involved 1320 patients with rotator cuff tears who subsequently received a primary arthroscopic RCR, with acromioplasty (n = 160) or without acromioplasty (n = 1160), performed by a single surgeon. Acromioplasty was performed if there was significant mechanical impingement on the rotator cuff. To assess outcomes, all patients completed a standardized, modified L’Insalata questionnaire in which they reported the level and severity of pain at rest and during activities. An examiner assessed shoulder strength and range of motion before and 1 week, 6 weeks, 12 weeks, and 6 months after surgery. Results: Patients who had RCR with concurrent acromioplasty had a greater level of pain and more frequent pain 1 week after surgery. However, at 6 months there were no differences between patients who underwent RCR with or without acromioplasty in any patient-reported outcome (level of pain with overhead activity, at rest and during sleep; frequency of pain with activity, sleep and extreme pain, difficulty of activity overhead and behind back, level of shoulder stiffness; and overall shoulder satisfaction). The postoperative re-tear rate in both groups was 13%. Conclusion: This study showed no additional benefit to acromioplasty in patients undergoing RCR.

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