Preoperative rotator cuff tendon integrity, tear size, and muscle atrophy and fatty infiltration are associated with structural outcomes of arthroscopic revision rotator cuff repair

Kim, Su Cheol; Shim, Seung Bo; Kim, Won Jae; Yoo, Jae Chul

doi:10.1007/s00167-021-06732-3

Cited by 19 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our data demonstrate that 3D muscle volumetry should be preferred in patients with full-thickness SSP tendon tears when the muscle volume needs to be quantified preoperatively in order to estimate the postoperative success rate after tendon repair procedures. This is in accordance with previous studies [ 17 ] and is important since various previous experimental and clinical studies have shown that significant SSP muscle atrophy is an important adverse prognostic factor affecting patients’ outcomes in addition to other conditions, e.g., fatty infiltration or severe tear size [ 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Section: Discussionsupporting

confidence: 92%

Three-Dimensional Software- and MR-Imaging-Based Muscle Volumetry Reveals Overestimation of Supraspinatus Muscle Atrophy Using Occupation Ratios in Full-Thickness Tendon Tears

et al. 2022

View full text Add to dashboard Cite

Supraspinatus muscle atrophy is widely determined from oblique-sagittal MRI by calculating the occupation ratio. This ex vivo and clinical study aimed to validate the accuracy of 3D software- and MR-imaging-based muscle volumetry, as well as to assess the influence of the tear pattern on the occupation ratio. Ten porcine muscle specimens were volumetrized using the physical water displacement volumetry as a standard of reference. A total of 149 individuals with intact supraspinatus tendons, partial tears, and full-thickness tears had 3T MRI. Two radiologists independently determined occupation ratio values. An excellent correlation with a Pearson’s r of 0.95 for the variables physical volumetry using the water displacement method and MR-imaging-based muscle volumetry using the software was found and formed the standard of reference for the patient study. The inter-reader reliability was 0.92 for occupation ratios. The correlation between occupation ratios and software-based muscle volumes was good in patients with intact tendons (0.84) and partial tears (0.93) but considerably lower in patients with full-thickness tears (0.68). Three-dimensional-software- and MR-imaging-based muscle volumetry is reliable and accurate. Compared to 3D muscle volumetry, the occupation ratio method overestimates supraspinatus muscle atrophy in full-thickness tears, which is most likely due to the medial retraction of the myotendinous unit.

show abstract

Section: Discussionsupporting

confidence: 92%

Three-Dimensional Software- and MR-Imaging-Based Muscle Volumetry Reveals Overestimation of Supraspinatus Muscle Atrophy Using Occupation Ratios in Full-Thickness Tendon Tears

et al. 2022

View full text Add to dashboard Cite

show abstract

“…As an important predictor of repair integrity, the overall fatty degeneration of RC muscles greatly influences postoperative shoulder strength and functional outcomes. 7,16,18 Thus, accurate and reliable evaluations of the Global-FI in the RC muscles are meaningful for appropriate treatment decision making and prognosis. 32 In clinical practice, a qualitative grading system, such as the Goutallier or Fuchs classification based on a single CT or MRI scan, has been widely used for assessing FI, aiming to view a single image as a predictor of the entire degenerative features throughout the RC.…”

Section: Discussionmentioning

confidence: 99%

“…13,22 The overall rotator cuff (RC) muscle fatty degeneration correlates with limited shoulder motion, decreased postoperative strength, and retear. 7,16,18 In this context, an accurate and repeatable assessment of the global RC muscle FI is imperative to help determine the most appropriate treatment options and prognosis and is a prerequisite for communication between doctors for appropriate decision making.…”

mentioning

confidence: 99%

The Modified Assessment Tool Based on Scapular Y-View for Global Fatty Infiltration in the Supraspinatus Muscle: Correlation, Predictive Performance, and Reliability Analyses

Liu

Han

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

Background: The accurate evaluation of rotator cuff (RC) fatty degeneration after tears is critical for appropriate surgical decision making and prognosis. However, there is currently no reliable and practical tool to reflect the global fatty infiltration (Global-FI) throughout the 3-dimensional (3D) volumetric RC muscles. Purpose: (1) To determine the correlations between 2 modified assessment tools and the Global-FI and their predictive performances and reliabilities for Global-FI prediction, and (2) to compare these predictive parameters with those of the conventional tool using a single scapular Y-view slice. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A total of 49 patients with full-thickness RC tears scheduled to undergo arthroscopic repairs were included, and their surgical shoulders underwent 6-point Dixon magnetic resonance imaging preoperatively. The Global-FI was measured by calculating the 3D-volumetric fat fraction (FF) of the whole supraspinatus muscle through all acquired oblique sagittal slices. As a commonly used radiological landmark, the scapular Y-view was used to evaluate single-plane fatty infiltration (Y-FI) by calculating the FF in 1 slice, defined as the conventional assessment tool. Two modified assessment tools expand the analytic imaging by integrating the FFs from the scapular Y-view slice and its neighboring slices, which were calculated by averaging the FFs of these 3 slices (meanY3-FI) and accumulating local 3D-volumetric FFs from 3 slices (volY3-FI), respectively. The correlations between 3 assessment tools and the Global-FI were analyzed, and the predictive performance for Global-FI prediction using these tools was determined by goodness of fit and agreement. Moreover, the inter- and intraobserver reliabilities of these assessment tools were evaluated. Similar analyses were performed in the small-medium, large, or massive tear subgroups. Results: The Y-FI was significantly higher than the Global-FI in all cases and tear size subgroups, while the 2 modified assessment tools (meanY3-FI and volY3-FI) did not significantly differ from the Global-FI. All assessment tools were significantly correlated with the Global-FI, but the meanY3-FI and volY3-FI showed stronger correlations than the Y-FI, which was also determined in different tear sizes. Moreover, the regression models of the meanY3-FI and volY3-FI showed superior goodness of fit to Y-FI in Global-FI prediction in all cases and subgroups, with larger coefficients of determination ( R2) and smaller root mean square errors. The predicted Global-FI using the regression model of volY3-FI had the best agreement with the measured Global-FI, followed by the meanY3-FI, both showing smaller biases and standard deviation of the percentage difference between predicted- and measured Global-FI than the conventional Y-FI. In addition, the 2 modified assessment tools achieved better interobserver and intraobserver reliabilities than the conventional tool in all cases and subgroups. Conclusion: Two modified assessment tools (meanY3-FI and volY3-FI) were comparable with the Global-FI of the whole supraspinatus muscle, showing stronger correlations with the Global-FI and better predictive performances and reliabilities than the conventional tool (Y-FI). Moreover, the volY3-FI was slightly superior to meanY3-FI in the predictive performance and reliability.

show abstract

“…Previous literature has reported that preoperative RC tear size and fatty infiltration are associated with tendon integrity and risk of retear after RCR. 12 , 22 , 26 Although somewhat counterintuitive, research has demonstrated a disconnect between imaging findings of RC disease and patients’ subjective experience of shoulder pain and function, 35 which may explain the present findings. Alternatively, it is possible that the PROMIS–UE questionnaire is not sensitive enough for the assessment of shoulder-specific recovery after RCR.…”

Section: Discussionmentioning

confidence: 58%

Determining the Time Required to Achieve Clinically Significant Outcomes on the PROMIS Upper Extremity Questionnaire After Arthroscopic Rotator Cuff Repair

Polce

Vadhera

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Clinically significant outcome (CSO) thresholds for the Patient-Reported Outcome Measurement Information System–Upper Extremity (PROMIS–UE) score have been previously defined after arthroscopic rotator cuff repair (RCR). However, the time required to achieve CSOs for the PROMIS–UE score is unknown. Purpose: To (1) determine the time required to achieve the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) score thresholds after RCR for the PROMIS–UE questionnaire and (2) identify patient factors associated with earlier or delayed achievement of these clinical benchmarks. Study Design: Case-control study; Level of evidence, 3. Methods: A prospectively maintained institutional database was retrospectively reviewed for consecutive patients who underwent RCR between January 2018 and January 2019. Patients were included if they completed the PROMIS–UE questionnaire both preoperatively and at standardized postoperative time intervals: 5 to 7 months (6-month time point), 11 to 13 months (1-year time point), and ≥23 months (2-year time point). Kaplan-Meier survival curves with interval censoring were used to define the cumulative percentage of patients who achieved the MCID, SCB, and PASS. Patient variables associated with earlier or delayed achievement of the MCID, SCB, and PASS were determined using Weibull parametric survival regression analysis. Results: Included were 105 patients undergoing RCR (age, 57.3 ± 10.3 years; body mass index, 31.5 ± 6.1 kg/m2). By 2-year follow-up, the cumulative percentage of patients achieving the MCID, SCB, and PASS was 86.7%, 76.2%, and 74.3%, respectively. The mean time required to reach the MCID, SCB, and PASS score thresholds was 9.5 ± 3.8, 10.3 ± 4.4, and 9.8 ± 4.6 months, respectively. Factors associated with delayed achievement of CSOs included greater baseline PROMIS–UE score (MCID and SCB) and workers’ compensation insurance (PASS). Greater baseline PROMIS–UE scores were associated with earlier achievement of the PASS. Conclusion: Most patients achieved CSOs for the PROMIS–UE within 12 months of RCR. Patient-specific factors found to be associated with earlier or delayed achievement of CSOs can be used to inform patient discussions on the expected timeline for recovery after RCR.

show abstract

Preoperative rotator cuff tendon integrity, tear size, and muscle atrophy and fatty infiltration are associated with structural outcomes of arthroscopic revision rotator cuff repair

Cited by 19 publications

References 28 publications

Three-Dimensional Software- and MR-Imaging-Based Muscle Volumetry Reveals Overestimation of Supraspinatus Muscle Atrophy Using Occupation Ratios in Full-Thickness Tendon Tears

Three-Dimensional Software- and MR-Imaging-Based Muscle Volumetry Reveals Overestimation of Supraspinatus Muscle Atrophy Using Occupation Ratios in Full-Thickness Tendon Tears

The Modified Assessment Tool Based on Scapular Y-View for Global Fatty Infiltration in the Supraspinatus Muscle: Correlation, Predictive Performance, and Reliability Analyses

Determining the Time Required to Achieve Clinically Significant Outcomes on the PROMIS Upper Extremity Questionnaire After Arthroscopic Rotator Cuff Repair

Contact Info

Product

Resources

About