Role of fatty infiltration in the pathophysiology and outcomes of rotator cuff tears

2011 ◽  
Vol 64 (1) ◽  
pp. 76-82 ◽  
Author(s):  
Salma Chaudhury ◽  
Joshua S. Dines ◽  
Demetris Delos ◽  
Russell F. Warren ◽  
Clifford Voigt ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Fatty Infiltration ◽  
Rotator Cuff Tears

scholarly journals Role of community diagnostic ultrasound examination in the diagnosis of full-thickness rotator cuff tears

2003 ◽  
Vol 73 (10) ◽  
pp. 797-799 ◽  
Author(s):  
Jerome A. Goldberg ◽  
Warwick J. M. Bruce ◽  
William Walsh ◽  
David H. Sonnabend
Keyword(s):  
Rotator Cuff ◽  
Ultrasound Examination ◽  
Diagnostic Ultrasound ◽  
Rotator Cuff Tears ◽  
Full Thickness

Delamination Does Not Affect Outcomes After Arthroscopic Rotator Cuff Repair as Compared With Nondelaminated Rotator Cuff Tears: A Study of 1043 Consecutive Cases

2019 ◽  
Vol 47 (3) ◽  
pp. 674-681 ◽  
Author(s):  
Jieun Kwon ◽  
Ye Hyun Lee ◽  
Sae Hoon Kim ◽  
Jung Hoon Ko ◽  
Byung Kyu Park ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Fatty Infiltration ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Symptom Duration ◽  
Negative Prognostic Factor ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Limited information is available regarding the characteristics of delaminated rotator cuff tears as compared with nondelaminated tears. Furthermore, there is conflicting information regarding the effects of delamination on the anatomic healing of repaired cuffs. Purpose: To evaluate the characteristics and anatomic outcomes of delaminated rotator cuff tears in comparison with nondelaminated tears to determine whether delamination is a negative prognostic factor affecting rotator cuff repair outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Between 2010 and 2014, 1043 patients were enrolled in the study to assess the prevalence of delamination. Among them, the findings from 531 patients who underwent magnetic resonance imaging or computed tomographic arthrography at least 1 year after surgery were included to determine whether delamination was a negative prognostic factor affecting the anatomic outcomes of arthroscopic rotator cuff repair. Delamination was assessed intraoperatively and defined by distinguishable edge cleavage tearing or interstitial horizontal gap between the articular and bursal surfaces of the torn tendon. One of 3 repair techniques (modified Mason Allen, single row, or double row) was used according to tear configuration and tendon mobilization. The authors evaluated visual analog scale scores for pain and satisfaction and American Shoulder and Elbow Surgeons scores to quantify clinical outcomes. Results: The incidence of delamination was 42.9% (447 of 1043). As compared with those with nondelaminated tears, patients with delaminated tears were older ( P < .001) and had longer symptom duration ( P = .019), larger tear sizes and retractions ( P < .001 for both), higher grades of fatty infiltration of the rotator cuff muscles (all P < .001), and poorer tendon quality ( P < .001). The overall healing failure rate was 19.0% (101 of 531). In univariate analysis, the rate of healing failure for the repaired cuffs was significantly higher in the delaminated group (delaminated tears, 60 of 238, 25.2%; nondelaminated tears, 41 of 293, 14.0%; P = .001). However, results of subgroup and multivariate analyses showed that the presence of delamination was ultimately not an independent risk factor for the failure of cuff healing. Between the delaminated and nondelaminated groups, there was no significant difference in postoperative functional outcomes. Conclusion: The results suggest that delaminated rotator cuff tears might represent chronic degenerative tears of longer symptom duration, with larger tear sizes and higher grades of fatty infiltration in older patients. It appears that delamination could be a confounding factor, not an independent prognostic factor, affecting rotator cuff healing.

Characteristics of human satellite cells from rotator cuff tears with or without fatty infiltration

2018 ◽  
Vol 27 (8) ◽  
pp. 1535
Author(s):  
Masashi Koide ◽  
Yoshihiro Hagiwara ◽  
Akira Ando ◽  
Takuya Sekiguchi ◽  
Kenji Kanazawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Satellite Cells ◽  
Fatty Infiltration ◽  
Rotator Cuff Tears

Can Preoperative Magnetic Resonance Imaging Predict the Reparability of Massive Rotator Cuff Tears?

2017 ◽  
Vol 45 (7) ◽  
pp. 1654-1663 ◽  
Author(s):  
Jung Youn Kim ◽  
Ji Seon Park ◽  
Yong Girl Rhee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Fatty Infiltration ◽  
Preoperative Magnetic Resonance Imaging ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Massive Rotator Cuff Tears ◽  
Preoperative Magnetic Resonance ◽  
Auc Value

Background: Numerous studies have shown preoperative fatty infiltration of rotator cuff muscles to be strongly negatively correlated with the successful repair of massive rotator cuff tears (RCTs). Purpose: To assess the association between factors identified on preoperative magnetic resonance imaging (MRI), especially infraspinatus fatty infiltration, and the reparability of massive RCTs. Study Design: Case-control study; Level of evidence, 3. Methods: We analyzed a total of 105 patients with massive RCTs for whom MRI was performed ≤6 months before arthroscopic procedures. The mean age of the patients was 62.7 years (range, 46-83 years), and 46 were men. Among them, complete repair was possible in 50 patients (48%) and not possible in 55 patients (52%). The tangent sign, fatty infiltration of the rotator cuff, and Patte classification were evaluated as predictors of reparability. Using the receiver operating characteristic curve and the area under the curve (AUC), the prediction accuracy of each variable and combinations of variables were measured. Results: Reparability was associated with fatty infiltration of the supraspinatus ( P = .0045) and infraspinatus ( P < .001) muscles, the tangent sign ( P = .0033), and the Patte classification ( P < .001) but not with fatty infiltration of the subscapularis and teres minor ( P = .425 and .132, respectively). The cut-off values for supraspinatus and infraspinatus fatty infiltration were grade >3 and grade >2, respectively. The examination of single variables revealed that infraspinatus fatty infiltration showed the highest AUC value (0.812; sensitivity: 0.86; specificity: 0.76), while the tangent sign showed the lowest AUC value (0.626; sensitivity: 0.38; specificity: 0.87). Among 2-variable combinations, the combination of infraspinatus fatty infiltration and the Patte classification showed the highest AUC value (0.874; sensitivity: 0.54; specificity: 0.96). The combination of 4 variables, that is, infraspinatus and supraspinatus fatty infiltration, the tangent sign, and the Patte classification, had an AUC of 0.866 (sensitivity: 0.28; specificity: 0.98), which was lower than the highest AUC value (0.874; sensitivity: 0.54; specificity: 0.96) among the 2-variable combinations. Conclusion: The tangent sign or Patte classification alone was not a predictive indicator of the reparability of massive RCTs. Among single variables, infraspinatus fatty infiltration was the most effective in predicting reparability, while the combination of Goutallier classification <3 of the infraspinatus and Patte classification ≤2 of the rotator cuff muscles was the most predictive among the combinations of variables. This information may help predict the reparability of massive RCTs.

MRI quantification of fatty infiltration and muscle atrophy in a mouse model of rotator cuff tears

2012 ◽  
Vol 31 (3) ◽  
pp. 421-426 ◽  
Author(s):  
Sanjum P. Samagh ◽  
Erik J. Kramer ◽  
Gerd Melkus ◽  
Dominique Laron ◽  
Blake M. Bodendorfer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Mouse Model ◽  
Muscle Atrophy ◽  
Fatty Infiltration ◽  
Rotator Cuff Tears

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

scholarly journals Effect of Muscle Quality on Operative and Nonoperative Treatment of Rotator Cuff Tears

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986301
Author(s):  
Micah Naimark ◽  
Thai Trinh ◽  
Christopher Robbins ◽  
Bridger Rodoni ◽  
James Carpenter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Fatty Infiltration ◽  
Nonoperative Treatment ◽  
Nonsurgical Treatment ◽  
Muscle Quality ◽  
Rotator Cuff Tears ◽  
The Impact ◽  
Surgical Group

Background: Rotator cuff muscle atrophy and fatty infiltration are predictors of negative outcomes after rotator cuff repair. However, the impact of muscle degeneration on nonsurgical treatment is unknown. Hypothesis: Rotator cuff muscle atrophy and fatty infiltration will reduce the outcomes of operative repair while having a minimal effect on nonsurgical treatment. Additionally, in the setting of atrophy and fatty infiltration, surgical and nonsurgical treatment will produce equivalent outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: Patients undergoing operative and nonoperative treatment of full-thickness rotator cuff tears were prospectively enrolled into a nonrandomized cohort study. Muscle quality was assessed on magnetic resonance imaging by use of the supraspinatus tangent sign, Warner atrophy, and Goutallier fatty infiltration classifications. Grading was performed by 2 independent observers who were blinded to patient treatment and outcomes. Normalized Western Ontario Rotator Cuff (WORC) index was the primary patient-reported outcome. Multivariate linear regression analysis was used to determine the impact of muscle quality on treatment outcomes. Results: The cohort consisted of 157 patients, 89 (57%) surgical and 68 (43%) nonsurgical, with a mean follow-up of 2.4 years (range, 1-5 years). Tangent sign had the best inter- and intrarater reliability, with kappa statistics of 0.81 and 0.86, respectively. Reliability for Warner atrophy was 0.69 to 0.76 and for Goutallier classification was 0.54 to 0.64. Overall, improvement in WORC scores was higher in the surgical group than the nonsurgical group (39.3 vs 21.2; P < .001). A positive tangent sign was the only independent predictor ( P < .01) of worse outcomes in the surgical group, accounting for an estimated 22-point lower improvement in WORC scores. Conclusion: A positive tangent sign was predictive of worse operative outcomes, resulting in equivalent improvements between surgical and nonsurgical treatment. The tangent sign is a reliable, prognostic indicator that clinicians can use when counseling patients on the optimal treatment of rotator cuff tears.

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