Changes in Appearance of Fatty Infiltration and Muscle Atrophy of Rotator Cuff Muscles on Magnetic Resonance Imaging After Rotator Cuff Repair: Establishing New Time-Zero Traits

Jo, Chris Hyunchul; Shin, Ji Sun

doi:10.1016/j.arthro.2012.10.006

Cited by 66 publications

(72 citation statements)

References 30 publications

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“…15 Additionally, immediate postoperative imaging has shown changes in muscle appearance after rotator cuff repair. 7 Finally, patients with eventual failed repairs did have larger baseline tear sizes and measurements of retraction. Future studies with larger patient cohorts can help clarify the relative contributions of each factor with multivariate modeling, although this is not reliable in the current group with limited patient numbers.…”

Section: Discussionmentioning

confidence: 90%

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

Lansdown

Lee

Sam

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Current evaluation of muscle fatty infiltration has been limited by subjective classifications. Quantitative fat evaluation through magnetic resonance imaging (MRI) may allow for an improved longitudinal evaluation of the effect of surgical repair on the progression of fatty infiltration.Hypotheses:We hypothesized that (1) patients with isolated full-thickness supraspinatus tendon tears would have less progression in fatty infiltration compared with patients with full-thickness tears of multiple tendons and (2) patients with eventual failed repair would have higher baseline levels of fatty infiltration.Study Design:Cohort study; Level of evidence, 2.Methods:Thirty-five patients with full-thickness rotator cuff tears were followed longitudinally. All patients received a shoulder MRI, including the iterative decomposition of echoes of asymmetric length (IDEAL) sequence for fat measurement, prior to surgical treatment and at 6 months after surgical repair. Fat fractions were recorded for all 4 rotator cuff muscles from measurements on 4 sagittal slices centered at the scapular-Y. Demographics and tear characteristics were recorded. Baseline and follow-up fat fractions were compared for patients with isolated supraspinatus tears versus multitendon tears and for patients with intact repairs versus failed repairs. Statistical significance was set at P < .05.Results:The mean fat fractions were significantly higher at follow-up than at baseline for the supraspinatus (9.8% ± 7.0% vs 8.3% ± 5.7%; P = .025) and infraspinatus (7.4% ± 6.1% vs 5.7% ± 4.4%; P = .027) muscles. Patients with multitendon tears showed no significant change for any rotator cuff muscle after repair. Patients with isolated supraspinatus tears showed a significant progression in the supraspinatus fat fraction from baseline to follow-up (from 6.8% ± 4.9% to 8.6% ± 6.8%; P = .0083). Baseline supraspinatus fat fractions were significantly higher in patients with eventual failed repairs compared with those with intact repairs (11.7% ± 6.8% vs 7.1% ± 4.8%; P = .037).Conclusion:Contrary to our initial hypothesis, patients with isolated supraspinatus tears showed a significant progression of fatty infiltration. Patients with eventual repair failure had higher baseline fat fractions in the supraspinatus.

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Section: Discussionmentioning

confidence: 90%

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

Lansdown

Lee

Sam

et al. 2017

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…These findings were confirmed in an experimental sheep model in which retracted tears had a greater amount of fatty infiltration [9]. A recent clinical study compared immediate postoperative MRI scans after rotator cuff repair with preoperative scans [18]. Interestingly, postoperative imaging showed an immediate improvement in Goutallier scores and tendon atrophy scores, suggesting that repositioning the tendon had a substantial effect on both.…”

Section: Limitationsmentioning

confidence: 82%

Classifications in Brief: Goutallier Classification of Fatty Infiltration of the Rotator Cuff Musculature

Somerson

Hsu

Gorbaty

et al. 2016

Clinical Orthopaedics &Amp; Related Research

100

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“…Fatty infiltration has been shown to be distributed non- uniformly throughout the muscle belly, 8,29 challenging the rationale of using a single image to evaluate fatty infiltration. 14 Jo and Shin 30 showed that new baseline images are needed following surgical repair because surgery moves the muscle and changes its appearance in the MR image. Additionally, the large image slices (e.g.…”

Section: Discussionmentioning

confidence: 99%

Assessments of Fatty Infiltration and Muscle Atrophy From a Single Magnetic Resonance Image Slice Are Not Predictive of 3-Dimensional Measurements

Vidt

Santago

Tuohy

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose The purpose was to 1) determine whether standard clinical muscle fatty infiltration and atrophy assessment techniques using a single image slice for patients with a rotator cuff tear (RCT) are correlated with three-dimensional measures in older individuals (60+ years), and 2) determine whether age-associated changes to muscle morphology and strength are compounded by a RCT. Methods Twenty older subjects were studied, 10 with a RCT of the supraspinatus (5M/5F) and 10 matched controls. Clinical imaging assessments (Goutallier, Fuchs scores; cross-sectional area ratio) were made for RCT subjects. Three-dimensional measurements of rotator cuff muscle and fat tissues were made for all subjects using MRI. Isometric joint moment was measured at the shoulder. Results There were no significant associations between single-image assessments and three-dimensional measurements of fatty infiltration for supraspinatus and infraspinatus. Compared to controls, RCT subjects had significantly increased fatty infiltration percentages for each rotator cuff muscle (all p≤0.023), reduced whole muscle volume for supraspinatus, infraspinatus, and subscapularis (all p≤0.038), and reduced fat-free muscle volume for supraspinatus, infraspinatus, and subscapularis (all p≤0.027). Only teres minor (p=0.017) fatty infiltration volume was significantly greater for RCT subjects. Adduction, flexion, and external rotation strength (all p≤0.021) were significantly reduced for RCT subjects, and muscle volume was a significant predictor of strength for all comparisons. Conclusions Clinical scores using a single image slice do not represent three-dimensional muscle measurements. Efficient methods are needed to more effectively capture three-dimensional information for clinical applications. RCT subjects had increased fatty infiltration percentages likely driven by muscle atrophy rather than increased fat volume. Muscle volume’s significant association with strength production suggests that treatments to preserve muscle volume should be pursued for older RCT patients. Level of Evidence Level II, diagnostic study, with development of diagnostic criteria on the basis of consecutive patients with universally applied reference “gold” standard.

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Changes in Appearance of Fatty Infiltration and Muscle Atrophy of Rotator Cuff Muscles on Magnetic Resonance Imaging After Rotator Cuff Repair: Establishing New Time-Zero Traits

Cited by 66 publications

References 30 publications

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

A Prospective, Quantitative Evaluation of Fatty Infiltration Before and After Rotator Cuff Repair

Classifications in Brief: Goutallier Classification of Fatty Infiltration of the Rotator Cuff Musculature

Assessments of Fatty Infiltration and Muscle Atrophy From a Single Magnetic Resonance Image Slice Are Not Predictive of 3-Dimensional Measurements

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