Long-term functional outcomes after repair of rotator cuff tears correlated with atrophy of the supraspinatus muscles on magnetic resonance images

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.

Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Schino

Augereau

Nich

2012

“…The FD in rotator cuff tear has received attention as a prognostic factor affecting anatomic and functional outcomes [7,9,[14][15][16]20]. The reliability of the classification system is a prerequisite for communication and comparison of results between studies.…”

Section: Discussionmentioning

confidence: 99%

Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles

Kim

Choi

et al. 2010

155

Fatty degeneration of the rotator cuff muscles is considered one of the most important factors for the outcomes of cuff repair. However, the reliability of the grading system is not well validated. Two specialists in musculoskeletal radiology and three shoulder fellowshiptrained orthopaedic surgeons reviewed the fatty degeneration grades of each cuff muscle of consecutive 75 fullthickness cuff tears. Fatty degeneration grades were assessed according to the systems of Goutallier et al. and Fuchs et al. using preoperative MR and postoperative CT arthrographies. The interclass correlation coefficient was analyzed to assess interobserver and intraobserver reliabilities. For interobserver reliability using the system of Goutallier et al. the interclass correlation coefficient was higher in MR arthrography (0.6-0.72) than in CT arthrography (0.43-0.6) and higher for radiologists (0.58-0.78) than for orthopaedic surgeons (0.32-0.68).

“…The time required for functional recovery reportedly is related to several factors including age [19], rotator cuff tear size [22,30], preoperative muscle weakness [28], and joint mobility [8]. In the literature, the information varies widely regarding the prognostic factors of rotator cuff repair [2,3,11,13].…”

Section: Introductionmentioning

confidence: 99%

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Manaka

Ito

Matsumoto

et al. 2011

Background Several studies have reported functional recovery of the shoulder after arthroscopic rotator cuff repair (ARCR). Preoperative estimation of the time required for functional recovery is important for determining surgical indications and for planning timing of the surgery and an appropriate postoperative physical therapy. Questions/purposes We therefore asked: (1) how long it takes to obtain functional recovery after ARCR, and (2) what preoperative factors influence functional recovery time. Patients and Methods We retrospectively evaluated 201 patients who had undergone ARCR. Using the Japanese Orthopaedic Association (JOA) shoulder scoring system, we defined the functional recovery period as the time required to achieve a score greater than 80% in each component. We evaluated the functional recovery periods and assessed preoperative influencing factors such as age, gender, shoulder stiffness, morphologic features of rotator cuff tears, and rotator cuff tear size. Results Sixty-three patients (31%) took less than 3 months, 81 patients (40%) took between 3 and 6 months, and 57 patients (28%) took greater than 6 months to achieve a score greater than 80% in each JOA shoulder assessment component. Younger patients without shoulder stiffness and with smaller rotator cuff tears had shorter functional recovery periods. Conclusions One hundred forty-four patients (72%) obtained functional recovery within 6 months after ARCR. Age, shoulder stiffness, and rotator cuff tear size influenced functional recovery time.