Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years
Abstract Background The extent of fatty infiltration and rotator cuff (RC) atrophy is crucial for the clinical results after rotator cuff repair (RCR). The purpose of this study was to evaluate changes in fatty infiltration and RC atrophy after revision RCR and to correlate them with functional outc...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06616-2 |
| _version_ | 1827917276386426880 |
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| author | Lucca Lacheta Sebastian Siebenlist Bastian Scheiderer Knut Beitzel Klaus Woertler Andreas B. Imhoff Stefan Buchmann Lukas Willinger |
| author_facet | Lucca Lacheta Sebastian Siebenlist Bastian Scheiderer Knut Beitzel Klaus Woertler Andreas B. Imhoff Stefan Buchmann Lukas Willinger |
| author_sort | Lucca Lacheta |
| collection | DOAJ |
| description | Abstract Background The extent of fatty infiltration and rotator cuff (RC) atrophy is crucial for the clinical results after rotator cuff repair (RCR). The purpose of this study was to evaluate changes in fatty infiltration and RC atrophy after revision RCR and to correlate them with functional outcome parameters. Methods Patients who underwent arthroscopic revision RCR for symptomatic recurrent full-thickness tear of the supraspinatus tendon between 2008 and 2014 and were retrospectively reviewed with a minimum follow up of 2 years. Magnetic resonance imaging (MRI) was performed pre- and postoperatively to assess 1) tendon integrity after revision RCR according to Sugaya classification, (2) RC atrophy according to Thomazeau classification, and (3) fatty infiltration according to Fuchs MRI classification. Constant score (CS) and the American Shoulder and Elbow Surgeon (ASES) score were used to correlate functional outcome, tendon integrity, and muscle degeneration. Results 19 patients (17 males and 2 females) with a mean age of 57.5 years (range, 34 to 72) were included into the study at a mean follow-up of 50.3 months (range, 24 – 101). At final evaluation, 9 patients (47%) presented with intact RCR and 10 patients (53%) suffered a re-tear after revision repair. No progress of fatty infiltration was observed postoperatively in the group with intact RC, atrophy progressed in only 1 out of 9 patient (11%). Fatty infiltration progressed in 5/10 patients (50%) and RC atrophy increased in 2/10 patients (20%) within the re-tear group. CS (42.7 ± 17.7 preop, 65.2 ± 20.1 postop) and ASES (47.7 ± 17.2 preop, 75.4 ± 23.7 postop) improved significantly from pre- to postoperatively (p < 0.001). A positive correlation between fatty infiltration and RC integrity was detected (r = 0.77, p < 0.01). No correlation between clinical outcome and tendon integrity or RC atrophy was observed. Conclusion Arthroscopic revision RCR leads to reliable functional outcomes even in case of a recurrent RC retear. An intact RCR maintains the preoperative state of fatty infiltration and muscle atrophy but does not lead to muscle regeneration. Level of evidence Level IV; Therapeutic study. |
| first_indexed | 2024-03-13T03:25:24Z |
| format | Article |
| id | doaj.art-9b9492bdadf24cffa976cd66d9cc9128 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-13T03:25:24Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-9b9492bdadf24cffa976cd66d9cc91282023-06-25T11:03:46ZengBMCBMC Musculoskeletal Disorders1471-24742023-06-012411710.1186/s12891-023-06616-2Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two yearsLucca Lacheta0Sebastian Siebenlist1Bastian Scheiderer2Knut Beitzel3Klaus Woertler4Andreas B. Imhoff5Stefan Buchmann6Lukas Willinger7Department of Orthopaedic Sports Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichMusculoskeletal Radiology Section, TUM School of Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichDepartment of Orthopaedic Sports Medicine, Technical University of MunichAbstract Background The extent of fatty infiltration and rotator cuff (RC) atrophy is crucial for the clinical results after rotator cuff repair (RCR). The purpose of this study was to evaluate changes in fatty infiltration and RC atrophy after revision RCR and to correlate them with functional outcome parameters. Methods Patients who underwent arthroscopic revision RCR for symptomatic recurrent full-thickness tear of the supraspinatus tendon between 2008 and 2014 and were retrospectively reviewed with a minimum follow up of 2 years. Magnetic resonance imaging (MRI) was performed pre- and postoperatively to assess 1) tendon integrity after revision RCR according to Sugaya classification, (2) RC atrophy according to Thomazeau classification, and (3) fatty infiltration according to Fuchs MRI classification. Constant score (CS) and the American Shoulder and Elbow Surgeon (ASES) score were used to correlate functional outcome, tendon integrity, and muscle degeneration. Results 19 patients (17 males and 2 females) with a mean age of 57.5 years (range, 34 to 72) were included into the study at a mean follow-up of 50.3 months (range, 24 – 101). At final evaluation, 9 patients (47%) presented with intact RCR and 10 patients (53%) suffered a re-tear after revision repair. No progress of fatty infiltration was observed postoperatively in the group with intact RC, atrophy progressed in only 1 out of 9 patient (11%). Fatty infiltration progressed in 5/10 patients (50%) and RC atrophy increased in 2/10 patients (20%) within the re-tear group. CS (42.7 ± 17.7 preop, 65.2 ± 20.1 postop) and ASES (47.7 ± 17.2 preop, 75.4 ± 23.7 postop) improved significantly from pre- to postoperatively (p < 0.001). A positive correlation between fatty infiltration and RC integrity was detected (r = 0.77, p < 0.01). No correlation between clinical outcome and tendon integrity or RC atrophy was observed. Conclusion Arthroscopic revision RCR leads to reliable functional outcomes even in case of a recurrent RC retear. An intact RCR maintains the preoperative state of fatty infiltration and muscle atrophy but does not lead to muscle regeneration. Level of evidence Level IV; Therapeutic study.https://doi.org/10.1186/s12891-023-06616-2Rotator cuffSupraspinatus tendonFatty infiltrationRotator cuff atrophyRevision rotator cuff repair |
| spellingShingle | Lucca Lacheta Sebastian Siebenlist Bastian Scheiderer Knut Beitzel Klaus Woertler Andreas B. Imhoff Stefan Buchmann Lukas Willinger Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years BMC Musculoskeletal Disorders Rotator cuff Supraspinatus tendon Fatty infiltration Rotator cuff atrophy Revision rotator cuff repair |
| title | Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| title_full | Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| title_fullStr | Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| title_full_unstemmed | Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| title_short | Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| title_sort | intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years |
| topic | Rotator cuff Supraspinatus tendon Fatty infiltration Rotator cuff atrophy Revision rotator cuff repair |
| url | https://doi.org/10.1186/s12891-023-06616-2 |
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