Abstract
ABSTRACTObjective: To evaluate the fatty infiltration and atrophy of the supraespinatus in the pre- and postoperative of a rotator cuff lesion (RCL), by MRI. Methods: Ten patients with full-thickness rotator cuff tears who had undergone surgical arthroscopic rotator cuff repair between September and December 2011 were included. This is a prospective study, with analysis and comparison of fatty infiltration and atrophy of the supraespinatus. The occupation ratio was measured using the magic selection tool in Adobe Photoshop CS3(r) on T1 oblique sagittal Y-view MRI. Through Photoshop, the proportion occupied by the muscle belly regarding its fossae was calculated. Results: There was a statistically significant increase in the muscle ratio (p=0.013) comparing images pre and postoperative, analyzed by the Wilcoxon T test. Conclusion: The proportion of the supraspinal muscle above the pit increases in the immediate postoperative period, probably due to the traction exerted on the tendon at the time of repair. Level of Evidence II, Cohort Study.
Highlights
Goutallier et al.[6] described fatty infiltration of the rotator cuff muscles (RC) after tendon rupture and created a classification system with five stages using computed tomography (CT) of infra and subscapularis spinal muscles, which became a reference in determining fatty infiltration
In this work, using the selected “y” image of the scapula one differs the notion of fatty infiltration of the supraspinatus, which is the amount of fat in the muscle and muscle atrophy that was estimated by the amount of supraspinatus muscle within its cavity.[18]
By means of MR and CT images, they calculated muscle occupancy rate of supraspinatus using Photoshop software CS3® and correlate the values found to the size of the injury and the degree of fatty infiltration according to Goutallier et al.[6]
Summary
Rotator cuff injury (RCI) is among the most common diseases affecting the shoulder, with an incidence of up to 54% of individuals over 60 years old,[1] and its chronicity may be accompanied by tendon retraction and fatty infiltration,[2] which is progressive and irreversible.[3,4,5] Initially, Goutallier et al.[6] described fatty infiltration of the rotator cuff muscles (RC) after tendon rupture and created a classification system with five stages using computed tomography (CT) of infra and subscapularis spinal muscles, which became a reference in determining fatty infiltration. The objective of this study was to evaluate fatty infiltration and atrophy of the supraspinatus in the preoperative period and immediately after repair in order to verify whether the traction exerted on the tendon to reinsert it alters the muscle in his fossa on immediate postoperative MR image.
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