Abstract
Introduction:Many factors could affect the supraspinatus (SSP) muscle after tendon rupture. We aimed to determine how infraspinatus and subscapularis tendon problems affect supraspinatus muscle atrophy associated with tears, in a retrospective cohort study conducted in a tertiary-level centre.Material and Methods:Fifty-eight patients with a full-thickness SSP tendon tear who fulfilled the inclusion criteria were enrolled in the study. They were evaluated for tear retraction, fatty degeneration, and other rotator cuff tendon pathologies. Supraspinatus muscle was assessed using the Goutallier classification, and its average area was also measured. Accompanying lesions of the subscapularis and infraspinatus tendons and degree of supraspinatus muscle atrophy were evaluated using magnetic resonance imaging.Results:Our results showed that supraspinatus tendon tears ranged between 3mm and 41mm, and the estimated average cross-sectional area of the SSP muscle was 247.6mm2. Any degree of infraspinatus tendon pathology, ranging from tendinosis to full-thickness tears, was significantly correlated with the SSP muscle area (P < 0.05). The subscapularis tendon pathologies did not show a similar correlation. The interobserver and intraobserver reliabilities of the measurements were graded as excellent.Conclusion:Impairment of any of the rotator cuff muscles may affect the other muscles inversely. Our study showed that all infraspinatus tendon pathologies and partial subscapularis tears affect and alter the SSP muscle belly. We suggest early intervention for supraspinatus tears to avoid further fatty degeneration, as muscle atrophy and fatty degeneration progress in combination with the accompanying lesions.
Highlights
Many factors could affect the supraspinatus (SSP) muscle after tendon rupture
The primary patient inclusion criteria in this study were the presence of fullthickness SSP tendon tears and "substantial pain." The term "substantial pain" was coined by Mall et al[7], defining any pain of ≥ 3 on a 10-point visual analogue pain scale that had lasted longer than six weeks, any pain considered to be greater than that normally experienced as part of daily living, any pain requiring the use of medications such as narcotics or non-steroidal anti-inflammatory drugs, or any pain that prompted a physician visit for evaluation
The study showed that the average size of the full-thickness SSP tendon tear retraction was 19.0mm, and the average SSP muscle area was 247.6mm[2]
Summary
We aimed to determine how infraspinatus and subscapularis tendon problems affect supraspinatus muscle atrophy associated with tears, in a retrospective cohort study conducted in a tertiary-level centre. Materials and Methods: Fifty-eight patients with a fullthickness SSP tendon tear who fulfilled the inclusion criteria were enrolled in the study They were evaluated for tear retraction, fatty degeneration, and other rotator cuff tendon pathologies. Accompanying lesions of the subscapularis and infraspinatus tendons and degree of supraspinatus muscle atrophy were evaluated using magnetic resonance imaging. Any degree of infraspinatus tendon pathology, ranging from tendinosis to full-thickness tears, was significantly correlated with the SSP muscle area (P < 0.05). Our study showed that all infraspinatus tendon pathologies and partial subscapularis tears affect and alter the SSP muscle belly. Previous studies have shown that tear size and location are determining factors in the development of muscle degeneration[6], but do not explain the mechanism of fatty degeneration
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