Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Blood flow velocity in the anterior humeral circumflex artery and tear size can predict synovitis severity in patients with rotator cuff tears

  • Received : 2023.08.21
  • Accepted : 2023.10.03
  • Published : 2024.03.01
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Abstract

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity.

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References

  1. Davis DE, Maltenfort M, Abboud JA, Getz C; Rothman Institute Shoulder Consortium Group and the Association of Clinical Elbow and Shoulder Surgeons. Classifying glenohumeral synovitis: a novel intraoperative scoring system. J Shoulder Elbow Surg 2017;26:2047-53. 
  2. Jo CH, Shin JS, Kim JE, Oh S. Macroscopic and microscopic assessments of the glenohumeral and subacromial synovitis in rotator cuff disease. BMC Musculoskelet Disord 2015;16:272. 
  3. Kim DH, Bae KC, Choi JH, Na SS, Hwang I, Cho CH. Chronicity is associated with the glenohumeral synovitis in patients with a rotator cuff tear. J Orthop Res 2021;39:2226-33. 
  4. Lee D, Lee KH, Jo YH, et al. Correlation between severity of synovitis and clinical features in rotator cuff tears. Clin Orthop Surg 2021;13:88-96. 
  5. Tan Z, Hendy BA, Zmistowski B, et al. Glenohumeral synovitis score predicts early shoulder stiffness following arthroscopic rotator cuff repair. J Orthop 2020;22:17-21. 
  6. Asano H, Terabayashi N, Kawashima K, et al. Blood flow in the anterior humeral circumflex artery reflects synovial inflammation of the shoulder joint in rotator cuff tears. JSES Int 2022;6:623-30. 
  7. Inoue A, Funakoshi T, Koga R, et al. Evaluation of hypervascularity in synovitis of the shoulder using ultrasound: comparison of preoperative ultrasound findings and intraoperative arthroscopic findings. JSES Int 2022;6:473-8. 
  8. Terabayashi N, Watanabe T, Matsumoto K, et al. Increased blood flow in the anterior humeral circumflex artery correlates with night pain in patients with rotator cuff tear. J Orthop Sci 2014;19:744-9. 
  9. Watanabe A, Katayama H, Machida T, Hirooka T. Synchronization of blood flow velocity in the anterior humeral circumflex artery and reduction in night pain after arthroscopic rotator cuff repair: a case report. Cureus 2022;14:e24468. 
  10. Bruyn GA, Naredo E, Damjanov N, et al. An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment. Ann Rheum Dis 2016;75:842-6. 
  11. Oo WM, Linklater JM, Hunter DJ. Imaging in knee osteoarthritis. Curr Opin Rheumatol 2017;29:86-95. 
  12. Oo WM, Linklater JM, Bennell KL, et al. Are OMERACT Knee Osteoarthritis Ultrasound Scores associated with pain severity, other symptoms, and radiographic and magnetic resonance imaging findings. J Rheumatol 2021;48:270-8. 
  13. Alilet M, Behr J, Nueffer JP, Barbier-Brion B, Aubry S. Multi-modal imaging of the subscapularis muscle. Insights Imaging 2016;7:779-91. 
  14. Wu CH, Chang KV, Su PH, Kuo WH, Chen WS, Wang TG. Dynamic ultrasonography to evaluate coracoacromial ligament displacement during motion in shoulders with supraspinatus tendon tears. J Orthop Res 2012;30:1430-4. 
  15. Poldoja E, Rahu M, Kask K, Bulecza T, Weyers I, Kolts I. Blood supply of the superior glenohumeral ligament: a gross anatomical and histological study. Austin J Anat 2016;3:1048. 
  16. Poldoja E, Rahu M, Kask K, Weyers I, Kolts I. Blood supply of the subacromial bursa and rotator cuff tendons on the bursal side. Knee Surg Sports Traumatol Arthrosc 2017;25:2041-6. 
  17. Thomazeau H, Boukobza E, Morcet N, Chaperon J, Langlais F. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin Orthop Relat Res 1997;(344):275-83. 
  18. Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg 2003;12:550-4. 
  19. Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM. Surgical repair of chronic rotator cuff tears: a prospective long-term study. J Bone Joint Surg Am 2001;83:71-7. 
  20. Cho CH, Bae KC, Kim DH. Incidence and risk factors for early postoperative stiffness after arthroscopic rotator cuff repair in patients without preoperative stiffness. Sci Rep 2022;12:3132. 
  21. Park EW, Cho JH, Cho CH, Sung DH, Kim DH. Comparison of shoulder ultrasonographic assessments between polymyalgia rheumatica and frozen shoulder in patients with bilateral shoulder pain: a comparative retrospective study. J Pers Med 2021;11:372. 
  22. Suzuki T, Yoshida R, Okamoto A, Seri Y. Semiquantitative evaluation of extrasynovial soft tissue inflammation in the shoulders of patients with polymyalgia rheumatica and elderly-onset rheumatoid arthritis by power Doppler ultrasound. Biomed Res Int 2017;2017:4272560. 
  23. Oo WM, Bo MT. Role of ultrasonography in knee osteoarthritis. J Clin Rheumatol 2016;22:324-9. 
  24. Abrams GD, Luria A, Carr RA, Rhodes C, Robinson WH, Sokolove J. Association of synovial inflammation and inflammatory mediators with glenohumeral rotator cuff pathology. J Shoulder Elbow Surg 2016;25:989-97. 
  25. Shindle MK, Chen CC, Robertson C, et al. Full-thickness supraspinatus tears are associated with more synovial inflammation and tissue degeneration than partial-thickness tears. J Shoulder Elbow Surg 2011;20:917-27. 
  26. Gotoh M, Hamada K, Yamakawa H, et al. Interleukin-1-induced subacromial synovitis and shoulder pain in rotator cuff diseases. Rheumatology (Oxford) 2001;40:995-1001. 
  27. Watanabe A, Ono Q, Nishigami T, Hirooka T, Machida H. Differences in risk factors for rotator cuff tears between elderly patients and young patients. Acta Med Okayama 2018;72:67-72. 
  28. Watanabe A, Ono-Matsukubo Q, Nishigami T, et al. Generalizability of eccentric exercise for patients with subacromial pain syndrome to real-world clinical practice: a propensity score-based analysis. Prog Rehabil Med 2021;6:20210019.