Comment on “Subacromial space volume in patients with rotator cuff tear: The effect of surgical repair” by Pepe et al.

Delaminated rotator cuff tear pertains to the horizontal split of the tendon substance. As reported previously, the presence of a delaminated tear and incidence of delaminated rotator cuff tear ranges from 38% to 92%. The different strain intensities applied across the rotator cuff tendon, and the shear stress between the bursal and articular layers seem to play a role in its pathogenesis. In a delaminated rotator cuff tear, the degree and direction of retraction between two layers differ, with accompanying intrasubstance cleavage. A surgeon therefore needs to consider and carefully evaluate the tear characteristics when repairing delaminated rotator cuff tear. Delaminated rotator cuff tear is considered to be a poor prognostic factor after rotator cuff repair, but numerous surgical repair techniques have been introduced and applied to resolve this problem. Recent literature has reported good clinical outcomes after delaminated rotator cuff repair.

Download Full-text

Polymorphisms and alterations in gene expression associated with rotator cuff tear and healing following surgical repair: a systematic review

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.07.045 ◽

2021 ◽

Vol 30 (1) ◽

pp. 200-215

Author(s):

Johanna J. Mousley ◽

Leaha-Marie Hill-Buxton ◽

Stephen D. Gill ◽

Sean L. McGee ◽

Richard S. Page

Keyword(s):

Gene Expression ◽

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Surgical Repair ◽

Cuff Tear

Download Full-text

Quantification of rotator cuff tear geometry: the repair ratio as a guide for surgical repair in crescent and U-shaped tears

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-009-0860-6 ◽

2009 ◽

Vol 130 (3) ◽

pp. 369-373 ◽

Cited By ~ 5

Author(s):

Utku Kandemir ◽

Robert B. Allaire ◽

Richard E. Debski ◽

Thay Q. Lee ◽

Patrick J. McMahon

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Surgical Repair ◽

Cuff Tear

Download Full-text

Comparison between the patients with surgery and without surgery after recommendation of surgical repair for symptomatic rotator cuff tear

Journal of Orthopaedic Science ◽

10.1016/j.jos.2017.09.018 ◽

2018 ◽

Vol 23 (1) ◽

pp. 64-69 ◽

Cited By ~ 6

Author(s):

Jae Chul Yoo ◽

Tae Kang Lim ◽

Dong Hyok Kim ◽

Kyoung-Hwan Koh

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Surgical Repair ◽

Cuff Tear

Download Full-text

Does the Rotator Cuff Tear Pattern Influence Clinical Outcomes After Surgical Repair?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118763107 ◽

2018 ◽

Vol 6 (3) ◽

pp. 232596711876310 ◽

Cited By ~ 3

Author(s):

Scott Watson ◽

Benjamin Allen ◽

Chris Robbins ◽

Asheesh Bedi ◽

Joel J. Gagnier ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Patient Reported Outcomes ◽

Surgical Repair ◽

Cuff Tear ◽

Patient Reported ◽

Outcome Scores ◽

Tear Pattern ◽

Cuff Repair ◽

Primary Predictor

Background: Limited literature exists regarding the influence of rotator cuff tear morphology on patient outcomes. Purpose: To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair. Study Design: Cohort study; Level of evidence, 3. Methods: Patients undergoing arthroscopic repair of known full-thickness rotator cuff tears were observed prospectively at regular intervals from baseline to 1 year. The tear pattern was classified at the time of surgery as crescent, U-shaped, or L-shaped. Primary outcome measures were the Western Ontario Rotator Cuff Index (WORC), the American Shoulder and Elbow Surgeons (ASES), and a visual analog scale (VAS) for pain. The tear pattern was evaluated as the primary predictor while controlling for variables known to affect rotator cuff outcomes. Mixed-methods regression and analysis of variance (ANOVA) were used to examine the effects of tear morphology on patient-reported outcomes after surgical repair from baseline to 1 year. Results: A total of 82 patients were included in the study (53 male, 29 female; mean age, 58 years [range, 41-75 years]). A crescent shape was the most common tear pattern (54%), followed by U-shaped (25%) and L-shaped tears (21%). There were no significant differences in outcome scores between the 3 groups at baseline. All 3 groups showed statistically significant improvement from baseline to 1 year, but analysis failed to show any predictive effect in the change in outcome scores from baseline to 1 year for the WORC, ASES, or VAS when tear pattern was the primary predictor. Further ANOVA also failed to show any significant difference in the change in outcome scores from baseline to 1 year for the WORC ( P = .96), ASES ( P = .71), or VAS ( P = .86). Conclusion: Rotator cuff tear pattern is not a predictor of functional outcomes after arthroscopic rotator cuff repair.

Download Full-text

The accuracy of plain radiographs in diagnosing degenerate rotator cuff disease

Shoulder & Elbow ◽

10.1177/1758573217743942 ◽

2017 ◽

Vol 11 (1_suppl) ◽

pp. 46-51 ◽

Cited By ~ 3

Author(s):

Kuen Chin ◽

Alex Chowdhury ◽

Dimitra Leivadiotou ◽

Helen Marmery ◽

Philip Michael Ahrens

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Arthroscopy ◽

Rotator Cuff Tears ◽

Subacromial Space ◽

Greater Tuberosity ◽

Plain Radiographs ◽

Cuff Tear ◽

Appropriate Treatment ◽

Cortical Irregularity

Background A number of radiographic signs have been previously demonstrated to be associated with degenerative rotator cuff tears. An ability to predict the presence of a tear by radiography would permit the early commencement of appropriate treatment and the avoidance of unnecessary invasive investigations. The aim of the present study was to determine the accuracy of using radiographic signs to predict the presence of a cuff tear on arthroscopy. Methods Fifty consecutive patients who had undergone shoulder arthroscopy and had pre-operative plain radiographs were included. Pre-operative radiographs were reviewed by a consultant shoulder surgeon, a consultant radiologist and a senior clinical fellow for the following signs: acromial spur; subjective reduction of subacromial space; sourcil sign; acromial acetabularization; os acromiale; greater tuberosity cortical irregularity; greater tuberosity sclerosis; humeral head rounding; cyst; and reduction in acromiohumeral head distance. Results The presence of tuberosity sclerosis ( p < 0.0001), tuberosity irregularities ( p < 0.0001), tuberosity cyst ( p = 0.004) and sourcil sign ( p = 0.019) was associated with the presence of a rotator cuff tear. The combined sensitivity of prediction of tear by the observers following radiographic review was 91.7%, with a combined negative predictive value of 80%. Conclusions The assessment of radiographs by senior clinicians is a useful tool for confirming the absence of a rotator cuff tear.

Download Full-text

Management of a Patient With an Isolated Greater Tuberosity Fracture and Rotator Cuff Tear

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2005.1723 ◽

2005 ◽

Author(s):

Linda E. Arslanian

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Greater Tuberosity ◽

Greater Tuberosity Fracture ◽

Cuff Tear

Download Full-text

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

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

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.

Download Full-text