Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Posterior decentering of the humeral head in patients with arthroscopic rotator cuff repair

  • Nakamura, Hidehiro (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Gotoh, Masafumi (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Honda, Hirokazu (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Mitsui, Yasuhiro (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Ohzono, Hiroki (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Shiba, Naoto (Department of Orthopedic Surgery, Kurume University) ;
  • Kume, Shinichiro (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Okawa, Takahiro (Department of Orthopedic Surgery, Kurume University Medical Center)
  • Received : 2021.09.21
  • Accepted : 2021.11.26
  • Published : 2022.03.01
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Abstract

Background: In some patients with rotator cuff tear (RCT), the axial view of magnetic resonance imaging (MRI) shows subtle posterior decentering (PD) of the humeral head from the glenoid fossa. This is considered to result from a loss of centralization that is typically produced by rotator cuff function. There are few reports on PD in RCT despite the common occurrence of posterior subluxation in degenerative joint disease. In this study, we investigated the effect of PD in arthroscopic rotator cuff repair (ARCR). Methods: We conducted a retrospective study of consecutive patients who underwent ARCR at our institute and were followed-up for at least 1 year. PD was identified as a 2-mm posterior shift of the humeral head relative to the glenoid fossa in the axial MRI view preoperatively. The tear size and fatty degeneration (FD, Goutallier classification) were also evaluated using preoperative MRI. Retears were evaluated through MRI at 1 year postoperatively. Results: We included 135 shoulders in this study. Ten instances of PD (including seven retears) were observed preoperatively. Fifteen retears (three and 12 retears in the small/medium and large/massive tear groups, respectively) were observed postoperatively. PD was significantly correlated with tear size, FD, and retear occurrence (p<0.01 each). The odds ratio for PD in retears was 34.1, which was greater than that for tear size ≥3 cm and FD grade ≥3. Conclusions: We concluded that large tear size and FD contribute to the occurrence of PD. Furthermore, PD could be a predictor of retear after ARCR.

Keywords

Acknowledgement

We would like to thank for Kenichiro Eshima and Yousuke Nakamura who gave us clinical support.

References

  1. Macaulay AA, Greiwe RM, Bigliani LU. Rotator cuff deficient arthritis of the glenohumeral joint. Clin Orthop Surg 2010;2:196-202. https://doi.org/10.4055/cios.2010.2.4.196
  2. Hamada K, Yamanaka K, Uchiyama Y, Mikasa T, Mikasa M. A radiographic classification of massive rotator cuff tear arthritis. Clin Orthop Relat Res 2011;469:2452-60. https://doi.org/10.1007/s11999-011-1896-9
  3. Chalmers PN, Salazar DH, Steger-May K, et al. Radiographic progression of arthritic changes in shoulders with degenerative rotator cuff tears. J Shoulder Elbow Surg 2016;25:1749-55. https://doi.org/10.1016/j.jse.2016.07.022
  4. Kuptniratsaikul V, Laohathaimongkol T, Umprai V, Yeekian C, Prasathaporn N. Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears. BMC Musculoskelet Disord 2019;20:111. https://doi.org/10.1186/s12891-019-2485-4
  5. Keener JD, Wei AS, Kim HM, Steger-May K, Yamaguchi K. Proximal humeral migration in shoulders with symptomatic and asymptomatic rotator cuff tears. J Bone Joint Surg Am 2009;91:1405-13. https://doi.org/10.2106/JBJS.H.00854
  6. Park SH, Choi CH, Yoon HK, Ha JW, Lee C, Chung K. What can the radiological parameters of superior migration of the humeral head tell us about the reparability of massive rotator cuff tears. PLoS One 2020;15:e0231843. https://doi.org/10.1371/journal.pone.0231843
  7. Taniguchi N, D'Lima DD, Suenaga N, et al. Translation of the humeral head scale is associated with success of rotator cuff repair for large-massive tears. BMC Musculoskelet Disord 2017;18:511. https://doi.org/10.1186/s12891-017-1874-9
  8. Yun G, Kang Y, Ahn JM, et al. Posterior decentering of the humeral head on shoulder MR arthrography: significant association with posterior synovial proliferation. AJR Am J Roentgenol 2017;208:1297-303. https://doi.org/10.2214/AJR.16.17198
  9. Kim JH, Seo HW. Relationship of posterior decentering of the humeral head with tear size and fatty degeneration in rotator cuff tear. Clin Shoulder Elb 2019;22:121-7. https://doi.org/10.5397/CISE.2019.22.3.121
  10. DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 1984;66:563-7. https://doi.org/10.2106/00004623-198466040-00011
  11. Honda H, Gotoh M, Mitsui Y, et al. Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying. J Orthop Surg Res 2018;13:297. https://doi.org/10.1186/s13018-018-0990-z
  12. Nakamura H, Gotoh M, Mitsui Y, et al. Factors affecting clinical outcome in patients with structural failure after arthroscopic rotator cuff repair. Arthroscopy 2016;32:732-9. https://doi.org/10.1016/j.arthro.2015.11.025
  13. Shimokobe H, Gotoh M, Honda H, et al. Risk factors for retear of large/massive rotator cuff tears after arthroscopic surgery: an analysis of tearing patterns. J Orthop Surg Res 2017;12:140. https://doi.org/10.1186/s13018-017-0643-7
  14. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears: a long-term observation. Clin Orthop Relat Res 1990;(254):92-6.
  15. Davidson JF, Burkhart SS, Richards DP, Campbell SE. Use of preoperative magnetic resonance imaging to predict rotator cuff tear pattern and method of repair. Arthroscopy 2005;21:1428.
  16. 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.
  17. Cheung S, Dillon E, Tham SC, et al. The presence of fatty infiltration in the infraspinatus: its relation with the condition of the supraspinatus tendon. Arthroscopy 2011;27:463-70. https://doi.org/10.1016/j.arthro.2010.09.014
  18. Kim JR, Cho YS, Ryu KJ, Kim JH. Clinical and radiographic outcomes after arthroscopic repair of massive rotator cuff tears using a suture bridge technique: assessment of repair integrity on magnetic resonance imaging. Am J Sports Med 2012;40:786-93. https://doi.org/10.1177/0363546511434546
  19. Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy 2009;25:30-9. https://doi.org/10.1016/j.arthro.2008.08.010
  20. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 1999;14:756-60. https://doi.org/10.1016/S0883-5403(99)90232-2
  21. Bercik MJ, Kruse K 2nd, Yalizis M, Gauci MO, Chaoui J, Walch G. A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg 2016;25:1601-6. https://doi.org/10.1016/j.jse.2016.03.010
  22. Ma CB, Xiao W, Salesky M, et al. Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty. JSES Int 2020;4:649-56. https://doi.org/10.1016/j.jseint.2020.04.009
  23. Walch G, Moraga C, Young A, Castellanos-Rosas J. Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg 2012;21:1526-33. https://doi.org/10.1016/j.jse.2011.11.030
  24. Juhan T, Stone M, Jalali O, et al. Irreparable rotator cuff tears: current treatment options. Orthop Rev (Pavia) 2019;11:8146.
  25. Sellers TR, Abdelfattah A, Frankle MA. Massive rotator cuff tear: when to consider reverse shoulder arthroplasty. Curr Rev Musculoskelet Med 2018;11:131-40. https://doi.org/10.1007/s12178-018-9467-2