Influence of fat infiltration, tear size, and post-operative tendon integrity on muscle contractility of repaired supraspinatus muscle.

Takuma Yuri,Hiromi Fujii,Nariyuki Mura,Yoshiro Kiyoshige,Hugo Giambini,Kyosuke Hoshikawa

doi:10.1007/s00590-021-03020-1

Abstract

BackgroundThe purpose of this study was to evaluate the effect of fat infiltration, tear size, and post-operative tendon integrity, on post-operative contractility.MethodsThirty-five patients who underwent rotator cuff repair were included. The fat infiltration, tear size, and post-operative tendon integrity were evaluated by Goutallier stage, Cofield classification, and Sugaya classification, respectively. The muscle elasticity at rest and at contraction was assessed by real-time tissue elastography pre- and one-year post-operatively. We defined the difference in elasticity between at rest and at contraction as the activity value which reflects muscle contractility.ResultsThe activity value in patients with Sugaya Type I tended to increase regardless of Cofield classification, whereas those with Sugaya Type III and IV tended to decrease. While the activity value in the patients classified as stage 1 and Type I tended to increase, patients classified as stage 2 showed decreased or constant in contractility even in those subjects classified as Type I. Stepwise multiple regression analysis showed both pre- (p = 0.004, r = -0.47) and post-operative activity values (p = 0.022, r = -0.39) to be significantly correlated only with the Goutallier stage.ConclusionMultiple regression analysis indicated only the Goutallier stage was a significant independent factor for contractility of the supraspinatus muscle. Supraspinatus muscle contractility in patients classified as Types III and IV based on the Sugaya classification tended to decrease post-operatively, while patients whose contractility increased post-operatively were characterized by having a Type I tendon integrity.

Highlights

Rotator cuff tears are a common problem that results in functional limitations [1]
Fat infiltration of the supraspinatus muscle was evaluated on the sagittal Y-view, where the most lateral image on which the scapular spine was in contact with the rest of the scapula, using magnetic resonance imaging (MRI) and the Goutallier stage[9, 10]: stage 1; stage 2; stage 3; and stage 4
Degree of fat infiltration showed no changes post-operatively compared to pre-operative evaluation

Summary

Introduction

Rotator cuff tears are a common problem that results in functional limitations [1]. While fat infiltration, tear size, and post-operative tendon integrity were considered to haveThe supraspinatus is the most common rotator cuff tendon that is involved in a rotator cuff tear [4,5,6]. Tear size, and post-operative tendon integrity were considered to have. Quantitative relationship between fat infiltration, tear size, tendon integrity, and post-operative contractility may need to be considered when clinicians choose interventions. The purpose of this study was to evaluate the effect of fat infiltration, tear size, and post-operative tendon integrity, on post-operative contractility. The fat infiltration, tear size, and postoperative tendon integrity were evaluated by Goutallier stage, Cofield classification, and Sugaya classification, respectively. Stepwise multiple regression analysis showed both pre- (p = 0.004, r = -0.47) and post-operative activity values (p = 0.022, r = -0.39) to be significantly correlated only with the Goutallier stage. Supraspinatus muscle contractility in patients classified as Types III and IV based on the Sugaya classification tended to decrease post-operatively, while patients whose contractility increased post-operatively were characterized by having a Type I tendon integrity

Objectives

Methods

Conclusion