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KMID : 1037920150020010034
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Arthroscopy and Orthopedic Sports Medicine
2015 Volume.2 No. 1 p.34 ~ p.41
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Progression of fatty degeneration of rotator cuff muscles after cuff repairs
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Moon Young-Lae
Kim Bo-Seon
Park Sang-Hag
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Abstract
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Background: To evaluate fatty degeneration and atrophy of rotator cuff muscles in patients with normal cuffs and in patients who received repairs of rotator cuff tears.
Methods: We chose 328 patients with normal cuffs, henceforth called the “normal group”. The normal group was subcategorized according to age. Further, we chose 41 patients with cuff tears, henceforth called the “cuff tear group”, who had received reparative surgeries. The cuff tear group was divided into 2 subgroups: a cuff “repaired group” that rotator cuff tears were successfully repaired and a “re-tear group” that cuff repairs were unsuccessful and led to a retear. The repaired group included 30 patients and the re-tear group included 11 patients. The radiological parameters (fatty degeneration and atrophy) and clinical outcomes (visual analogue scale, UCLA, Constant, and Oxford scores) were evaluated.
Results: We found that the extent of fatty degeneration and atrophy of the cuff muscles was irrespective of the aging process. Compared to the normal group, we found the cuff tear group had a significantly greater fatty degeneration and atrophy of the rotator cuff muscles. Within the cuff tear group, the re-tear group had a significantly more deteriorated fatty degeneration at the follow-up magnetic resonance imaging (MRI) than at the initial MRI (P = 0.024) and more muscle atrophy than the repaired group; there was no statistical significance. Although the clinical markers were more satisfactory in the repaired group than the re-tear group after surgery, there was no statistical significance.
Conclusion: Fatty degeneration and atrophy of the rotator cuff muscles were not affected by the normal aging process. However, we found that fatty degeneration was accelerated following cuff tears even when the tear had been repaired. Lastly, we found that a preoperative fatty degeneration of more than grade 3 was associated with a higher re-tear rate of the rotator cuffs.
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KEYWORD
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Rotator cuff, Tear, Fatty, Degeneration, Atrophy
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