Does the Fatty Infiltration Influence the Re-tear Rate and Functional Outcome After Rotator Cuff Repair? A Systematic Review and Meta-analysis

Yang, Zhenjie; Zhang, Mingtao; Liu, Tao; Zhang, Borong; Wang, Xihao; Liang, Junwen; Jiang, Jin; Yun, Xiang-Dong

doi:10.1007/s43465-022-00807-0

Cited by 6 publications

(3 citation statements)

References 48 publications

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“…FI of the rotator cuff has important implications for post‐operative outcomes. Research indicates that the magnitude of FI prior to rotator cuff surgical repair has a significant effect on healing, clinical outcomes, and re‐tear rates 8–10 . A recent systematic review studied the association between supraspinatus (SS) and infraspinatus (IS) re‐tear rates and preoperative FI, as documented using the Goutallier 5‐stage grading system (higher grade representing higher FI) 9 .…”

Section: Introductionmentioning

confidence: 99%

“…Research indicates that the magnitude of FI prior to rotator cuff surgical repair has a significant effect on healing, clinical outcomes, and re-tear rates. [8][9][10] A recent systematic review studied the association between supraspinatus (SS) and infraspinatus (IS) re-tear rates and preoperative FI, as documented using the Goutallier 5-stage grading system (higher grade representing higher FI). 9 Marked increases in retear rates of the SS and IS occurred with increasing FI, with a 4-5 fold increase in re-tear rate demonstrated from lowest to highest preoperative Goutallier grades.…”

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confidence: 99%

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Investigating the relationship between quantitative‐based ultrasound and MRI estimations of rotator cuff fatty infiltration

Mahna,

Boulanger,

Gatti

et al. 2024

J of Clinical Ultrasound

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IntroductionFatty infiltration (FI) of the rotator cuff has important clinical implications. Quantitatively estimating FI using ultrasound (US) has considerable benefits for assessing FI in a non‐invasive, accessible manner. This research investigated whether FI of the supraspinatus (SS) and infraspinatus (IS), estimated using US was related to intramuscular fat fractions measured from magnetic resonance images (MRI).MethodsData from 12 healthy young adult participants were used for analysis. US images of the SS and IS were captured using multiple transducer placement techniques from which echogenicity of the muscle region was quantified. Shoulder MRI were captured from which SS and IS were manually segmented and intramuscular fat fractions calculated. Six upper limb strength exertions were performed, resisted by a hand dynamometer.ResultsIS and SS echogenicity explained a significant amount of variance in MRI fat fractions for certain body positions and transducer techniques. Echogenicity agreement was higher for IS than SS. Significant relationships were identified between strength exertions and both echogenicity and MRI muscle volume, but not MRI fat fraction.ConclusionsThis research provides preliminary evidence showing that quantitative‐based US methods can be used to estimate MRI calculated fat fractions for the rotator cuff.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Investigating the relationship between quantitative‐based ultrasound and MRI estimations of rotator cuff fatty infiltration

Mahna,

Boulanger,

Gatti

et al. 2024

J of Clinical Ultrasound

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“… 4 , 11 , 21 , 23 , 29 , 30 However, there is no consensus on whether FI and atrophy of rotator cuff could predict shoulder function. 1 , 2 , 11 , 20 , 23 , 26 , 30 , 35 The discordance or lack of cutoff values for Goutallier grade further contribute to the inconvenience of using FI as a predictor for postoperative functional outcomes. Some studies have emphasized the importance of defining FI as Goutallier grade ≥3 in RCTs, 4 , 19 some studies have used a cutoff value of Goutallier grade 2 for analysis, 11 , 17 whereas other studies have not mentioned a cut-off value.…”

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confidence: 99%

The Posterosuperior Tetralogy Scoring System as a Practical Tool to Predict Shoulder Function After Posterosuperior Large-to-Massive Rotator Cuff Repairs

Guo,

Zhu,

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Fatty infiltration (FI) or atrophy alone has been found to be inaccurate in predicting shoulder function after repair of large-to-massive rotator cuff tears (L/MRCTs), especially when a diverse extent of FI and atrophy presents in multiple rotator cuff muscles. Purpose/Hypothesis: The Posterosuperior Tetralogy Scoring System (PS-Tetra Score), which integrates FI and atrophy, was proposed to predict shoulder function after surgery. It was hypothesized was that a PS-Tetra Score ≥3 would be a risk factor for poor shoulder function after repair of posterosuperior L/MRCTs and would possess greater diagnostic value than using isolated FI or atrophy of the supraspinatus (SSP) or infraspinatus (ISP). Study Design: Case-control study; Level of evidence, 3. Methods: A total of 187 arthroscopic repairs of posterosuperior L/MRCTs were reviewed. Magnetic resonance imaging evaluations were performed of FI and atrophy of the SSP and ISP, teres minor hypertrophy, tendon retraction, and acromiohumeral distance. A postoperative American Shoulder and Elbow Surgeons (ASES) score of 70 was used to subgroup patients according to shoulder function. Univariate and multivariate analyses were performed to determine the risk factors of poor shoulder function (ASES ≤70). The diagnostic values of different indicators for predicting shoulder function were evaluated. Results: In univariate analysis, female sex, higher Goutallier grade of the SSP and ISP, positive SSP tangent sign, and PS-Tetra Score ≥3 was significantly associated with ASES score ≤70, whereas in binary logistic regression analysis, a PS-Tetra Score ≥3 was the only significant risk factor for poor shoulder function. The occurrence rate of poor function in shoulders with a PS-Tetra Score of 0, 1, 2, 3, and 4 was 0% (0/52), 0% (0/52), 19.57% (9/46), 58.06% (18/31), and 83.33% (5/6), respectively. PS-Tetra Score ≥3 possessed higher crude agreement (87.70%), specificity (90.97%), positive predictive value (62.16%), and area under the receiver operating characteristic curve (0.814) than the other 3 indicators, with relatively high negative predictive value (94.00%) and moderate sensitivity (71.88%). Conclusion: PS-Tetra Score ≥3 was a risk factor of poor shoulder function after repair of posterosuperior L/MRCTs and possessed greater diagnostic value than using isolated FI or atrophy of SSP or ISP alone for predicting shoulder function.

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The addition of mesenchymal stem cells in a bioabsorbable scaffold does not enhance tendon healing after a repair of rotator cuff tear

Christogiannis,

Mastrokalos,

Papagelopoulos

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of the study is to evaluate the healing potential of a full‐thickness tendon defect in the rotator cuff of rabbits using a bioabsorbable scaffold impregnated with bone marrow–mesenchymal stem cells (BM‐MSCs) or rotator cuff‐derived mesenchymal stem cells (RC‐MSCs).MethodsSixteen adult rabbits were subjected to a full‐thickness rotator cuff deficit. Rabbits were randomly assigned to four groups of four animals. In Group 0 (control), the deficit was left untreated. In Group 1, the deficit was treated with a single synthetic scaffold alone. In Group 2, the deficit was treated with the previous scaffold loaded with allogeneic BM‐MSCs. In Group 3, the deficit was treated with the previous scaffold loaded with allogenic RC‐MSCs. After animal sacrifice, tissue samples were subjected to histological and immunohistochemical analysis.ResultsGroup 1 showed the highest mean tendon maturing score (15.3 ± 0.9) postoperatively, being significantly higher, in comparison to groups 0, 2 and 3 (p = 0.01, 0.02 and 0.01, respectively). Group 1 showed the highest mean collagen I/collagen III ratio (1.4 ± 0.8) postoperatively but without any statistical significance.ConclusionsThe utilization of MSCs in rotator cuff repair in a rabbit model has not been associated with an enhancement in tendon healing in 16 weeks postoperatively, in comparison to controls and bioabsorbable scaffolds. The addition of MSCs does not result in better rotator cuff healing.Level of EvidenceNot applicable. This is an animal study.

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Does the Fatty Infiltration Influence the Re-tear Rate and Functional Outcome After Rotator Cuff Repair? A Systematic Review and Meta-analysis

Cited by 6 publications

References 48 publications

Investigating the relationship between quantitative‐based ultrasound and MRI estimations of rotator cuff fatty infiltration

Investigating the relationship between quantitative‐based ultrasound and MRI estimations of rotator cuff fatty infiltration

The Posterosuperior Tetralogy Scoring System as a Practical Tool to Predict Shoulder Function After Posterosuperior Large-to-Massive Rotator Cuff Repairs

The addition of mesenchymal stem cells in a bioabsorbable scaffold does not enhance tendon healing after a repair of rotator cuff tear

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