Abstract

BackgroundAlthough a loss of rotator cuff integrity leads to the superior migration of the humeral head, the parameters that characterize the anterolateral migration of the humeral head have not been established. The purpose of this study was to investigate the correlation between the translation of the humeral head scale (T-scale) and clinical outcomes of rotator cuff repair, as well as the correlation between the T-scale and radiologic parameters.MethodsOne hundred thirty-five consecutive patients with full-thickness rotator cuff tears underwent primary rotator cuff repair. The T-scale, which indicates the distance from the center of the humeral head to the lateral coracoacromial arch, was measured on axial computed tomography scans, and the acromiohumeral interval (AHI) was measured radiographically. The correlation of the two parameters with the clinical scores of the Japanese Orthopaedic Association and University of California–Los Angeles scores and active forward elevation (FE) were evaluated at the preoperative and postoperative stages, respectively.ResultsThe postoperative T-scale and AHI correlated well with the postoperative FE and clinical scores in the patients with large-massive tears but not in those patients with small-medium tears and preoperative large-massive tears. A significant correlation was observed between the postoperative T-scale and AHI. The T-scale was subject to cuff repair integrity.ConclusionsWe demonstrated that the postoperative T-scale was well correlated with the clinical results and postoperative AHI after rotator cuff repair for large-massive tears, indicating that poor outcomes are associated with combined superior and anterolateral migration of the humeral head following retears.

Highlights

  • A loss of rotator cuff integrity leads to the superior migration of the humeral head, the parameters that characterize the anterolateral migration of the humeral head have not been established

  • The results indicated that age, gender, affected side, and follow-up period were similar between the small-medium tear group and large-massive tear group

  • A significant increase was observed in the Japanese Orthopaedic Association (JOA) score (P < 0.0001), University of California–Los Angeles (UCLA) score (P < 0.0001), and active forward elevation (FE) range (P < 0.0001) in both the small-medium tear and largemassive tear groups and for the entire group of shoulders studied (Table 2)

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Summary

Introduction

A loss of rotator cuff integrity leads to the superior migration of the humeral head, the parameters that characterize the anterolateral migration of the humeral head have not been established. A loss of rotator cuff integrity creates an unstable fulcrum of motion, leading to the superior migration of the humeral head on the glenoid and altered glenohumeral joint biomechanics [1]. Irreparable rotator cuff deficiencies and coracoacromial arch losses are complicated by the compromise of the anterior portion of the deltoid muscle as a result of Taniguchi et al BMC Musculoskeletal Disorders (2017) 18:511 surgical procedures, in patients with a prior open repair [15]. The combined loss of the rotator cuff, coracoacromial arch, and anterior deltoid integrity results in dynamic anterosuperior instability that occurs during attempted elevation [16]

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