Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Magnetic resonance imaging analysis of rotator cuff tear after shoulder dislocation in a patient older than 40 years

  • Kim, Jung-Han (Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Park, Jin-Woo (Department of Orthopedic Surgery, Gimhae-Sarang Hospital) ;
  • Heo, Si-Young (Department of Orthopedic Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Noh, Young-Min (Department of Orthopedic Surgery, Dong-A University Hospital, Dong-A University College of Medicine)
  • Received : 2020.08.04
  • Accepted : 2020.08.19
  • Published : 2020.09.01
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Abstract

Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Conclusions: Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

Keywords

References

  1. Maier M, Geiger EV, Ilius C, Frank J, Marzi I. Midterm results after operatively stabilised shoulder dislocations in elderly patients. Int Orthop 2009;33:719-23. https://doi.org/10.1007/s00264-008-0578-z
  2. Hovelius L, Eriksson K, Fredin H, et al. Recurrences after initial dislocation of the shoulder: results of a prospective study of treatment. J Bone Joint Surg Am 1983;65:343-9. https://doi.org/10.2106/00004623-198365030-00008
  3. Pevny T, Hunter RE, Freeman JR. Primary traumatic anterior shoulder dislocation in patients 40 years of age and older. Arthroscopy 1998;14:289-94. https://doi.org/10.1016/S0749-8063(98)70145-8
  4. Bassett RW, Cofield RH. Acute tears of the rotator cuff: the timing of surgical repair. Clin Orthop Relat Res 1983;(175):18-24.
  5. Braune C, von Eisenhart-Rothe R, Welsch F, Teufel M, Jaeger A. Mid-term results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg 2003;123:419-24. https://doi.org/10.1007/s00402-003-0548-2
  6. Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. In: NIHR health technology assessment programme: executive summaries. Southampton: NIHR Journals Library; 2003.
  7. Loehr JF, Helmig P, Sojbjerg JO, Jung A. Shoulder instability caused by rotator cuff lesions: an in vitro study. Clin Orthop Relat Res 1994;(304):84-90.
  8. Porcellini G, Paladini P, Campi F, Paganelli M. Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years. Arthroscopy 2006;22:270-6. https://doi.org/10.1016/j.arthro.2005.12.015
  9. Neviaser RJ, Neviaser TJ, Neviaser JS. Anterior dislocation of the shoulder and rotator cuff rupture. Clin Orthop Relat Res 1993;(291):103-6.
  10. Neviaser RJ, Neviaser TJ. Recurrent instability of the shoulder after age 40. J Shoulder Elbow Surg 1995;4:416-8. https://doi.org/10.1016/S1058-2746(05)80032-1
  11. Dwyer T, Razmjou H, Henry P, Gosselin-Fournier S, Holtby R. Association between pre-operative magnetic resonance imaging and reparability of large and massive rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 2015;23:415-22. https://doi.org/10.1007/s00167-013-2745-z
  12. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999;8:599-605. https://doi.org/10.1016/S1058-2746(99)90097-6
  13. Keener JD, Steger-May K, Stobbs G, Yamaguchi K. Asymptomatic rotator cuff tears: patient demographics and baseline shoulder function. J Shoulder Elbow Surg 2010;19:1191-8. https://doi.org/10.1016/j.jse.2010.07.017
  14. Minagawa H, Yamamoto N, Abe H, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. J Orthop 2013;10:8-12. https://doi.org/10.1016/j.jor.2013.01.008
  15. Yamamoto A, Takagishi K, Kobayashi T, Shitara H, Osawa T. Factors involved in the presence of symptoms associated with rotator cuff tears: a comparison of asymptomatic and symptomatic rotator cuff tears in the general population. J Shoulder Elbow Surg 2011;20:1133-7. https://doi.org/10.1016/j.jse.2011.01.011
  16. Sorensen AK, Bak K, Krarup AL, et al. Acute rotator cuff tear: do we miss the early diagnosis?: a prospective study showing a high incidence of rotator cuff tears after shoulder trauma. J Shoulder Elbow Surg 2007;16:174-80. https://doi.org/10.1016/j.jse.2006.06.010
  17. Neviaser RJ, Neviaser TJ, Neviaser JS. Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in the older patient. J Bone Joint Surg Am 1988;70:1308-11. https://doi.org/10.2106/00004623-198870090-00005
  18. Loew M, Porschke FB, Riedmann S, Magosch P, Lichtenberg S. Zur Unterscheidung zwischen traumatischer und degenerativer Rotatorenmanschettenruptur: eine klinische und radiologische Untersuchung. Obere Extremitat 2014;9:209-14. https://doi.org/10.1007/s11678-014-0271-3
  19. Loew M, Magosch P, Lichtenberg S, Habermeyer P, Porschke F. How to discriminate between acute traumatic and chronic degenerative rotator cuff lesions: an analysis of specific criteria on radiography and magnetic resonance imaging. J Shoulder Elbow Surg 2015;24:1685-93. https://doi.org/10.1016/j.jse.2015.06.005
  20. Balich SM, Sheley RC, Brown TR, Sauser DD, Quinn SF. MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology 1997;204:191-4. https://doi.org/10.1148/radiology.204.1.9205245
  21. Owen RS, Iannotti JP, Kneeland JB, Dalinka MK, Deren JA, Oleaga L. Shoulder after surgery: MR imaging with surgical validation. Radiology 1993;186:443-7. https://doi.org/10.1148/radiology.186.2.8421748
  22. Zanetti M, Jost B, Hodler J, Gerber C. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects. Skeletal Radiol 2000;29:314-9. https://doi.org/10.1007/s002560000203
  23. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994;(304):78-83.
  24. Hantes ME, Karidakis GK, Vlychou M, Varitimidis S, Dailiana Z, Malizos KN. A comparison of early versus delayed repair of traumatic rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 2011;19:1766-70. https://doi.org/10.1007/s00167-011-1396-1
  25. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006;88:1699-704. https://doi.org/10.2106/00004623-200608000-00002
  26. Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg 2001;10:199-203. https://doi.org/10.1067/mse.2001.113086
  27. Inman VT, Saunders JB, Abbott LC. Observations on the function of the shoulder joint. J Bone Joint Surg 1944;26:1-30.
  28. Walch G, Edwards TB, Boulahia A, Nove-Josserand L, Neyton L, Szabo I. Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J Shoulder Elbow Surg 2005;14:238-46. https://doi.org/10.1016/j.jse.2004.07.008
  29. Park JS, Park HJ, Kim SH, Oh JH. Prognostic factors affecting rotator cuff healing after arthroscopic repair in small to medium-sized tears. Am J Sports Med 2015;43:2386-92. https://doi.org/10.1177/0363546515594449
  30. Hsu HC, Luo ZP, Cofield RH, An KN. Influence of rotator cuff tearing on glenohumeral stability. J Shoulder Elbow Surg 1997;6:413-22. https://doi.org/10.1016/S1058-2746(97)70047-8
  31. Pouliart N, Gagey O. Concomitant rotator cuff and capsuloligamentous lesions of the shoulder: a cadaver study. Arthroscopy 2006;22:728-35. https://doi.org/10.1016/j.arthro.2006.03.015
  32. Sonnabend DH. Treatment of primary anterior shoulder dislocation in patients older than 40 years of age: conservative versus operative. Clin Orthop Relat Res 1994;(304):74-7.
  33. Simank HG, Dauer G, Schneider S, Loew M. Incidence of rotator cuff tears in shoulder dislocations and results of therapy in older patients. Arch Orthop Trauma Surg 2006;126:235-40. https://doi.org/10.1007/s00402-005-0034-0
  34. Melis B, Wall B, Walch G. Natural history of infraspinatus fatty infiltration in rotator cuff tears. J Shoulder Elbow Surg 2010;19:757-63. https://doi.org/10.1016/j.jse.2009.12.002
  35. Gimbel JA, van Kleunen JP, Lake SP, Williams GR, Soslowsky LJ. The role of repair tension on tendon to bone healing in an animal model of chronic rotator cuff tears. J Biomech 2007;40:561-8. https://doi.org/10.1016/j.jbiomech.2006.02.010
  36. Gimbel JA, van Kleunen JP, Mehta S, Perry SM, Williams GR, Soslowsky LJ. Supraspinatus tendon organizational and mechanical properties in a chronic rotator cuff tear animal model. J Biomech 2004;37:739-49. https://doi.org/10.1016/j.jbiomech.2003.09.019
  37. Barton ER, Gimbel JA, Williams GR, Soslowsky LJ. Rat supraspinatus muscle atrophy after tendon detachment. J Orthop Res 2005;23:259-65. https://doi.org/10.1016/j.orthres.2004.08.018
  38. Hersche O, Gerber C. Passive tension in the supraspinatus musculotendinous unit after long-standing rupture of its tendon: a preliminary report. J Shoulder Elbow Surg 1998;7:393-6. https://doi.org/10.1016/S1058-2746(98)90030-1
  39. Iannotti JP. The rotator cuff: current concepts and complex problems. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1998.

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