scholarly journals Rotator Cuff Tear Pain and Tear Size and Scapulohumeral Rhythm

2009 ◽  
Vol 44 (2) ◽  
pp. 148-159 ◽  
Author(s):  
Jason S. Scibek ◽  
James E. Carpenter ◽  
Richard E. Hughes
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
The Body ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Scapular Kinematics ◽  
Cuff Tear ◽  
Before And After ◽  
Lidocaine Injection ◽  
Tear Size

Abstract Context: The body of knowledge concerning shoulder kinematics in patients with rotator cuff tears is increasing. However, the level of understanding regarding how pain and tear size affect these kinematic patterns is minimal. Objective: To identify relationships between pain associated with a full-thickness rotator cuff tear, tear size, and scapulohumeral rhythm (SHR) and to determine whether pain and tear size serve as predictors of SHR. Design: A test-retest design was used to quantify pain and SHR before and after a subacromial lidocaine injection. Correlation and multivariate analyses were used to identify relationships among pain, tear size, and SHR. Setting: Orthopaedic biomechanics research laboratory. Patients or Other Participants: Fifteen patients (age range, 40–75 years) with diagnosed full-thickness rotator cuff tears participated. They were experiencing pain at the time of testing. Intervention(s): Shoulder kinematic data were collected with an electromagnetic tracking system before and after the patient received a lidocaine injection. Main Outcome Measure(s): Pain was rated using a visual analog scale. Three-dimensional scapular kinematics and glenohumeral elevation were assessed. Scapular kinematics included anterior-posterior tilt, medial-lateral tilt, and upward-downward rotation. A regression model was used to calculate SHR (scapular kinematics to glenohumeral elevation) for phases of humeral elevation and lowering. Results: Linear relationships were identified between initial pain scores and SHR and between tear size and SHR, representing an increased reliance on scapular motion with increasing pain and tear size. Pain was identified as an independent predictor of SHR, whereas significant findings for the effect of tear size on SHR and the interaction between pain and tear size were limited. Conclusions: We noted an increased reliance on scapular contributions to overall humeral elevation with increasing levels of pain and rotator cuff tear size. Pain associated with a rotator cuff tear serves as a primary contributor to the kinematic patterns exhibited in patients with rotator cuff tears.

scholarly journals Relationship of the Sagittal Extent of Rotator Cuff Tears to the Grade of 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
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.

IMPACT OF PAIN ON SHOULDER ELEVATION VELOCITY IN PATIENTS WITH ROTATOR CUFF TEARS

2010 ◽  
Vol 13 (01) ◽  
pp. 23-33 ◽  
Author(s):  
Jason S. Scibek ◽  
Amy G. Mell ◽  
Brian K. Downie ◽  
Riann Palmieri-Smith ◽  
Richard E. Hughes
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Tracking System ◽  
Human Motion ◽  
Rotator Cuff Tears ◽  
Movement Velocity ◽  
Cuff Tear ◽  
Shoulder Movement ◽  
Tear Size ◽  
Shoulder Elevation

Pain is routinely implicated as a factor when considering impaired movement in injured populations. Movement velocity is often considered during the rehabilitation process; unfortunately our understanding of pain's impact on shoulder movement velocity in rotator cuff tear patients is less understood. Therefore, the purpose of this study was to test the hypothesis that there would be an increase in peak and mean shoulder elevation velocities following the decrease of shoulder pain in rotator cuff tear patients, regardless of tear size. Fifteen subjects with full-thickness rotator cuff tears (RCT) performed humeral elevation and lowering in three planes before and after receiving a lidocaine injection to relieve pain. Pain was assessed using a visual analog scale. Humeral elevation velocity data were collected using an electromagnetic tracking system. A significant reduction in pain (pre-injection 3.53 ± 1.99; post-injection 1.23 ± 1.43) resulted in significant increases in maximum and mean humeral elevation velocities. Mean shoulder elevation and lowering velocities increased 15.10 ± 2.45% while maximum shoulder movement velocities increased 12.77 ± 3.93%. Furthermore, no significant relationships were noted between tear size and movement velocity. These significant increases in movement velocity provide evidence to further support the notion that human motion can be inhibited by injury-associated pain, and that by reducing that pain through clinical interventions, human movement can be impacted in a positive fashion.

scholarly journals Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

2018 ◽  
Vol 1 (21;1) ◽  
pp. E173-E180 ◽  
Author(s):  
Sangbong Ko
Keyword(s):  
Neuropathic Pain ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Full Thickness ◽  
Cuff Tear ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size

Background: Until now, few studies had investigated the neuropathic pain component in patients with a rotator cuff tear (RCT). Objectives: The aim of the study was to identify the neuropathic pain component in patients with RCT and to determine the factors correlated with neuropathic pain in patients with RCT. Study Design: Prospective, cohort, prognostic study. Setting: Study patients who required arthroscopic rotator cuff repair were analyzed in a hospital setting. Methods: We prospectively studied 101 patients who were less than 60 years old with fullthickness tears requiring arthroscopic rotator cuff repair and met the inclusion and exclusion criteria. Multiple regression analysis was performed to identify variables that independently affected neuropathic pain in patients with a RCT. We use Douleur neuropathique 4 questionnaire (DN4) to assess neuropathic pain, which was ≥ 4 points of the DN4 questionaire. The visual analog scale (VAS) for the most severe pain within 4 weeks before admission and mean pain level during the last 4 weeks were checked. The atrophy grades of the rotator cuff muscles were classified on magnetic resonance images according to the Goutallier classification. The size and medial retraction of the RCT were measured during arthroscopic repair for RCT. Results: Sixteen (15.8%) of the 101 patients had neuropathic pain according to the cutoff values on the DN4 questionnaire for diagnosing neuropathic pain. The neuropathic pain group had significantly higher prevalence of smoking (P = 0.042), more mean VAS during last 4 weeks (P = 0.008), larger cuff tear (P = 0.003), more medial retraction of cuff (P = 0.016), and severe fatty degeneration of rotator cuff muscles (supraspinatus, P < 0.001; subscapularis, P < 0.001; and infraspinatus, P = 0.003) than the nonneuropathic pain group. The multiple logistic regression analyses showed that more mean VAS during the last 4 weeks and tear size of a rotator cuff were independent of other factors for the neuropathic pain of the patients with a full-thickness RCT. Limitations: Small sample size is the first limitation of this study. Conclusions: The prevalence of neuropathic pain in patients with a full-thickness RCT requiring arthroscopic rotator cuff repair was 15.8 % according to the DN4 questionnaire. The neuropathic pain component was more relevant to the severity of pain and tear size in the patients with a full-thickness RCT. It is important to be aware of the existence of neuropathic pain when treating a patient presenting with pain due to a RCT because accompanying neuropathy with a RCT could have a worse effect on repair of a RCT. IRB approval and clinical trial registration number: CR-15-045 Key words: Shoulder, rotator cuff tear, arthroscopic rotator cuff repair, neuropathic pain

Diagnostic value of the axial view of magnetic resonance imaging to identify two-dimensional shapes of full-thickness rotator cuff tears

2020 ◽  
Vol 61 (11) ◽  
pp. 1545-1552
Author(s):  
Sung-Weon Jung ◽  
Jin-Woo Jin ◽  
Dong-Hee Kim ◽  
Hyeon-Soo Kim ◽  
Gwang-Eun Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Fatty Infiltration ◽  
Rotator Cuff Tears ◽  
Two Dimensional ◽  
Resonance Imaging ◽  
Cuff Tear ◽  
Tear Size

Background Coronal and sagittal views of magnetic resonance imaging (MRI) were used to determine rotator cuff tear size and fatty infiltration, but these images were not enough to identify the tear shape. Purpose To correlate the preoperative axial MRI views and arthroscopic surgical findings to identify the two-dimensional shapes in rotator cuff tears. Material and Methods This study included 166 patients who underwent arthroscopic repair between 2015 and 2018. Preoperative coronal, sagittal, and axial MRI views were evaluated for tear size and geographic configuration in axial sections, and the length and the width were measured and were matched with arthroscopic surgical views by lateral portals. Results The agreement of axial MRI views with the arthroscopic view was 88.0% in crescent, 97.2% in longitudinal, 78.6% in massive, and 100% in rotator cuff tear arthropathy. The mean agreement rate of axial MRI views with arthroscopic view was 81.9%. Mean mediolateral and anteroposterior tear sizes on axial MRI were 16.68 mm and 19.33 mm, respectively. Mean mediolateral and anteroposterior tear sizes by arthroscopic view were 21.49 mm and 21.04 mm, respectively. Tear sizes by MRI axial images were 71.3% of arthroscopic view. SST/IST degenerative changes were noted in most patients with massive tears and rotator cuff arthropathy ( P = 0.001). Conclusion Rotator cuff tear shape on preoperative axial MRI view had close agreement (81.9%) with arthroscopic findings by lateral portal, and tear size by preoperative axial MRI views was 71.3% of that of arthroscopic view. Axial MRI views helped to predict the geometric tear shape of rotator cuff tears.

Mini-Open Rotator Cuff Tear Repair: An Institutional Experience with a Midterm Follow-up

2018 ◽  
Vol 20 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Adil Bashir ◽  
Suleiman Seth ◽  
Iftikhar H. Wani ◽  
Munir Farooq ◽  
Naseem ul Gani ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Fixation Method ◽  
Full Thickness ◽  
Open Procedure ◽  
Cuff Tear ◽  
Rotator Cuff Tear Repair ◽  
Mini Open

Background. Rotator cuff tears have long been recognised as a cause of pain and disability. Over the past decades the treatment of rotator cuff tears has evolved from an open procedure to a mini-open procedure to an all-arthroscopic one. The indications and benefits of each of the procedures are still debated. The purpose of this study was to observe the results of “Mini-open repair rotator cuff tear”. Material and methods. This was a prospective study conducted in the postgraduate department of Ortho­paedics Government Medical College, Srinagar, from March 2013 to January 2018 with cases followed up for a minimum of 3 years. This study included 50 patients of either sex with non-massive full thickness tears of rotator cuff. Results. The mean UCLA score improved from 10.96 preoperatively to 30.68 at final follow-up. Overall, 88% of the patients achieved excellent or good results and 92% were satisfied. No significant difference was noted in functional outcomes between traumatic and degenerative tears. Size of tear seems to be a determining factor in the functional outcome. Stiffness as a complication occurred in two patients. Conclusion. 1. Mini-open rotator cuff tear repair eliminated sym­pto­matic full thickness rotator cuff tears with significant improvement in functional scores. 2. There were no major complications of the surgical procedure adop­ted or the fixation method used. 3. Mini-open rotator cuff repair remains a useful technique despite advan­ces in arthroscopy.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

scholarly journals Full-thickness rotator cuff tear in rat results in distinct temporal expression of multiple proteases in tendon, muscle, and cartilage

2018 ◽  
Vol 37 (2) ◽  
pp. 490-502 ◽  
Author(s):  
Elda A. Treviño ◽  
Jennifer McFaline-Figueroa ◽  
Robert E. Guldberg ◽  
Manu O. Platt ◽  
Johnna S. Temenoff
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Full Thickness ◽  
Temporal Expression ◽  
Cuff Tear ◽  
And Cartilage

scholarly journals DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

2017 ◽  
Vol 10 (4) ◽  
pp. 373 ◽  
Author(s):  
Surendra Umesh Kamath ◽  
Sunil Murthy
Keyword(s):  
Rotator Cuff ◽  
Total Cholesterol ◽  
Rotator Cuff Tear ◽  
Indian Population ◽  
Statistical Significance ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Cuff Tear

Background:  Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear.  Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints.  We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group.  21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.   

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