Does Open Repair of Anterosuperior Rotator Cuff Tear Prevent Muscular Atrophy and Fatty Infiltration?

Abstract

BackgroundRepair of cuff tears involving rotator interval reportedly improves function. However, it is unclear whether successful repair prevents shoulder degenerative changes. Questions/purposes Therefore, we (1) documented the minimal 4-year function of patients who underwent open surgical repair for rotator interval tears; (2) evaluated repaired tendon healing with postoperative MRI; and (3) sought to determine the influence of tendon healing on muscular and glenohumeral joint changes. Methods We retrospectively analyzed 22 patients (23 shoulders) treated by open transosseous reinsertion of supraspinatus and subscapularis tendons. The mean age of the patients was 53 years (range, 37-64 years). The tear was traumatic in four cases. Repair healing and muscular changes were assessed using MRI. The minimum followup was 46 months (mean, 75 months; range, 46-103 months).Results We observed an improvement in the absolute Constant-Murley score from 63 points preoperatively to 76 points postoperatively. With the last followup MRI, the supraspinatus tendon repair had failed in two of the 23 shoulders, whereas the subscapularis tendon repair had healed in all cases.

Rotator Cuff Fatty Infiltration and Atrophy Are Associated With Functional Outcomes in Anatomic Shoulder Arthroplasty

“…Once healing of the repaired tendon occurred, supraspinatus muscle atrophy did not progress. In another study, however, fatty infiltration of the rotator cuff muscles as measured on MRI increased despite successful tendon repair [1]. It is possible that fatty infiltration and atrophy of the rotator cuff resulting from loss of the tendon insertion may occur by a different pathophysiologic mechanism than fatty infiltration and atrophy in the setting arthritis resulting from inactivity, pain, and reduced ROM.…”

Does partial tear repair of adjacent tendons improve the outcome of supraspinatus tendonfull-thickness tear reinsertion?

“…in 119 patients. For this specific focus, we selected patients from our database, who have been reported as part of previous studies [13,14]. The criteria for inclusion in this report were:…”

Pullout strength of all suture anchors in the repair of rotator cuff tears: a biomechanical study

“…Rotator cuff repair by tendon reinsertion on the proximal humerus aims to treat pain and initial functional impairment and prevent the occurrence of eccentric shoulder osteoarthritis [1][2][3][4][5]. Due to the development of minimally invasive techniques (miniopen or arthroscopic), anchors have gradually replaced transosseous sutures, which have been the gold standard for cuff surgery [6,7].…”