scholarly journals Magnetic Resonance Imaging Classifications of Rotator Cuff Tear Are Associated with Different Shoulder Outcome Scores

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xingzhen Hu ◽  
Xiaoxing Wang ◽  
Weisi Mao ◽  
Lingling Ying ◽  
Zongzhang Huang
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Supraspinatus Tendon ◽  
Shoulder Injuries ◽  
Resonance Imaging ◽  
Simple Shoulder Test ◽  
Cuff Tear ◽  
Significant Difference ◽  
Outcome Scores

Objective. Rotator cuff tear (RCT) accounts for 50% of shoulder injuries, leading to chronic pain and disability in the upper extremity. The study is conducted to investigate the association between resonance imaging (MRI) classifications of patients with RCT and different shoulder outcome scores. Methods. From September 2018 to October 2019, 112 patients underwent shoulder MRI at our institution and selected as eligible study subjects according to inclusion and exclusion criteria. Among these 112 patients, 69 cases had confirmed history of shoulder trauma and 43 cases were due to chronic shoulder joint pain. The shoulder function of patients was evaluated by University of California Los Angeles Shoulder (UCLA) score, Constant-Murley score, Shoulder Pain and Disability Index (SPADI), and simple shoulder test (SST). Results. Among the 112 patients, there were 34 cases, 58 cases, and 20 cases with MRI classifications at grades I, II, and III, respectively. There was no significant difference in the injured tendons in patients with different MRI classifications ( P > 0.05 ). The injury at the supraspinatus was more common. The scores of UCLA, Constant-Murley, and SST in patients with MRI grading at grade I were significantly higher than those at grades II and III ( P < 0.05 ), which were significantly higher in patients at grade II than those at grade III ( P < 0.05 ). SPADI score in patients with MRI grading at grade I was significantly lower than that at grades II and III ( P < 0.05 ), while there was no significant difference in SPADI score between patients at grades II and III ( P > 0.05 ). MRI classifications were negatively correlated with scores of UCLA, Constant-Murley, and SST ( P > 0.05 ). There was no significant correlation between MRI grade and SPADI scores ( P > 0.05 ). Conclusion. The supraspinatus tendon injury is more common in patients with RCT. MRI classifications were negatively correlated with scores of UCLA, Constant-Murley, and SST.

A Novel Acromion Radiological Classification and Its Clinical Application Study: Comparing Rockwood Tilt View with Arthroscopic Findings in 101 Shoulders

2020 ◽  
Vol 10 (5) ◽  
pp. 1184-1189
Author(s):  
Yingchun Zhu ◽  
Xuewen Jia ◽  
Zhanping Jin ◽  
Yunfeng Mi ◽  
Zheyang Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Classification System ◽  
Supraspinatus Tendon ◽  
New Classification ◽  
Tendon Tear ◽  
Cuff Tear ◽  
Observer Reliability ◽  
Traditional Classification

Background: It is estimated that more than 25% of general population more than 60 years old experience rotator cuff tear, acromial impingement syndrome is one of the most common causes. Morphology of acromion is an important extrinsic factor in the development of rotator cuff tear. The traditional classification of the acromion by Bigliani et al. based on supraspinatus outlet view has been widely used, but due to the high requirements for patients to obtain true supraspinatus outlet view and the poor inter-observer reliability, it brings lots of limitations to the clinical use of this classification. In our clinical work, we have noticed that the formation of acromial anterolateral spur on Rockwood tilt view has some relationship to a rotator cuff tear. Objectives: To develop a new classification of acromion based on the subacromial impingement theory and the Rockwood tilt view. And explore the application value of the new classification in the diagnosis and treatment of rotator cuff tear. Methods: From January 2017 to December 2017, 101 cases of shoulder arthroscopic surgeries for impingement syndrome or rotator cuff tear were retrospectively analyzed. We developed a new classification of the acromion based on the Rockwood tilt view as type I flat acromion, type II bump acromion and type III impingement acromion. The status of the supraspinatus tendon was also recorded as no tear, partial-thickness tear, and full-thickness tear. We tested the inter-observer and intra-observer reliability of the new classification system (Kappa value) and analyzed the correlation between the acromion morphology and the rupture of the supraspinatus tendon. Results: In all 101 cases, the most common type was the impingement acromion with 46 patients (45.5%), followed by bump acromion in 37 patients (36.6%), and the flat acromion in 18 patients (17.8%). The inter-observer reliability of the new classification system was significantly better than that of the traditional classification (0.826 vs. 0.281). The incidence of supraspinatus tendon tear in the patients with impingement acromion was significantly higher than that of the other two types of acromion (ϰ2 = 50.316,P < 0.05). Conclusion: The Rockwood tilt view can well demonstrate the exact architecture of the anterolateral acromion spur. The new classification based on Rockwood tilt view has high reliability and good reproducibility. The type III impingement acromion correlates highly with the supraspinatus tendon tear. Level of evidence: Level II.

Comparison of Clinical and Structural Outcomes by Subscapularis Tendon Status in Massive Rotator Cuff Tear

2017 ◽  
Vol 45 (11) ◽  
pp. 2555-2562 ◽  
Author(s):  
Sung Hyun Lee ◽  
Dae Jin Nam ◽  
Se Jin Kim ◽  
Jeong Woo Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Resonance Imaging ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Massive Rotator Cuff Tears

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

scholarly journals Recombinant Human Bone Morphogenetic Proteins-4 Enhanced the Tendon-to-bone Attachment Healing in a Murine Model of Rotator Cuff Tear: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Huabin Chen ◽  
Zhanwen Wang ◽  
Li Zhou ◽  
Bing Wu ◽  
Hongbin Lu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Bone Morphogenetic Proteins ◽  
Murine Model ◽  
Controlled Trial ◽  
Supraspinatus Tendon ◽  
Control Group ◽  
Cuff Tear ◽  
Tendon Insertion ◽  
And Control

Abstract Background: Injuries on tendon-to-bone attachment (TBA) are common clinical dilemmas. Bone Morphogenetic Proteins-4 (BMP-4) has been found the potency in chondrogenesis. But there is rare studies focusing the influence of BMP-4 on the TBA healing. Thus, the objective of this study was to explore the effect of BMP-4 on the healing of TBA in murine model of rotator cuff tear.Methods: 120 mature C57BL/6 mice (12 weeks old) were randomly divided into BMP-4 group, noggin (an inhibitor of all BMP activities) group and control group after being established an injury model of supraspinatus tendon insertion. At week 2 and 4 after surgery, the supraspinatus tendon- humerus complex (SSTHC) were harvested for microradiographic, histologic, immunofluorescent and biomechanical evaluations.Results: Radiographic data showed that BMP-4 was able to improve the quality of subchondral bone, manifested as higher BV/TV, Tb.N, TB.Th, and lower Tb.Sp. Histologically, the BMP-4 group at week-2 and -4 showed better BTA healing interface, characterized by better organizational integration and remodeling, thicker fibrocartilage layer and more fibrocartilage cells. Immunoflorescence evaluation demonstrated the number of SOX 9 positive cells in the BMP-4 group was significantly more than that in the control or noggin group at postoperative weeks 2 and 4 (p<0.05 for all). Mechanical testing results demonstrated the failure load and stiffness in the BMP-4 group were significantly higher (p<0.05 for both), while in the noggin group were lower (p<0.05 for both), compared to the control group at postoperative weeks 4.Conclusion: BMP-4 might enhance the TBA healing by promoting the regeneration of fibrocartilaginous enthesis and mineralization, while noggin inhibited this process.Clinical Relevance: BMP-4 may be a potential therapy to augment TBA healing, and finally lead to more rapid rehabilitation and reduce risk of recurrent repair.

A Follow-Up Study of Rotator Cuff Tear Using Magnetic Resonance Imaging

2018 ◽  
Vol 53 (1) ◽  
pp. 38 ◽  
Author(s):  
Jun-Sung Won ◽  
Woo-Seung Lee ◽  
Jae-Hong Park ◽  
Seung-Nam Ko ◽  
In-Wook Seo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Resonance Imaging ◽  
Cuff Tear ◽  
Follow Up Study

Supraspinatus tendon organizational and mechanical properties in a chronic rotator cuff tear animal model

2004 ◽  
Vol 37 (5) ◽  
pp. 739-749 ◽  
Author(s):  
Jonathan A. Gimbel ◽  
Jonathan P. Van Kleunen ◽  
Samir Mehta ◽  
Stephanie M. Perry ◽  
Gerald R. Williams ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Animal Model ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Supraspinatus Tendon ◽  
Cuff Tear

scholarly journals Comparison of the Separate and Combined Effects of Physiotherapy Treatment and Corticosteroid Injection on the Range of Motion and Pain in Nontraumatic Rotator Cuff Tear: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shaahin Hajivandi ◽  
Atousa Dachek ◽  
Amirhossein Salimi ◽  
Hesan Jelodari Mamaghani ◽  
Seyed Peyman Mirghaderi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Tear ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Age Distribution ◽  
Full Thickness ◽  
Cuff Tear ◽  
Significant Difference

Background. Surgical treatment and conservative treatment is the options to improve pain, function, and range of motion following rotator cuff tear. In this study, we aimed to compare the effects of physiotherapy and corticosteroid injections on the function, pain, and range of motion in patients with full-thickness rotator cuff tearing separately and simultaneously. Methods. A total of 96 patients were randomly assigned to the study and divided into 3 groups of 32 patients. DASH questionnaire and VAS criterion were completed by all three groups, and the range of motions of all groups was measured by a goniometer. Then, the first group underwent 12 sessions of physiotherapy twice a week for 6 weeks; the second group received 80 mg of methylprednisolone and 1 ml of lidocaine 2% in two stages, 21 days apart; and the third group received 80 mg of methylprednisolone and 1 ml of lidocaine 2%, and after 2 days, 6 sessions of physiotherapy twice a week for 3 weeks were prescribed. In the end, the questionnaire was filled out by the patient, and the range of emotions was assessed with a goniometer. Results. More than 80% of patients in each group were female. There was no significant difference between the gender and age distribution of the groups. The mean age in physiotherapy, steroid, and physiotherapy + steroid groups was 51.78 ± 7.37, 52.37 ± 6.61, and 50.87 ± 5.65, respectively. The combination of physiotherapy + steroid intervention was more effective in reducing VAS and DASH scores than physiotherapy or steroid injection alone. Goniometric findings showed that treatments that included the steroid injection approach (steroid injection and steroid + physiotherapy) had a more dramatic effect on improving the patients’ range of motion than physiotherapy alone. Conclusions. Among the conservative approaches of treating full-thickness rotator cuff tear, a combination of steroid injection and physiotherapy is more effective significantly in comparison with either treatment alone. This trial is registered with IRCT20200102045987N1.

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