Background: Tears of the supraspinatus are common and incompletely understood. The degree of fatty infiltration into the muscle is perceived to be a determining factor of successful surgical repair and postoperative function. It is the hypothesis of this study that the degree of central tendon retraction (CTR) as seen on magnetic resonance imaging corresponds to the amount of fatty infiltration classified according to the Goutallier grading system.
Materials And Methods: Magnetic resonance imaging scans of the supraspinatus were reviewed in 2 identifiable groups: 143 scans with no tear (NT) and 148 scans with a full-thickness tear (FTT) and CTR. The degree of CTR and the corresponding Goutallier grade were measured. The difference in Goutallier grade between the NT and FTT groups was measured with the Mann-Whitney test. The relationship between Goutallier grade and increasing amount of CTR was described by use of Spearman rank correlation. Studying the difference between the Goutallier grades and CTR was achieved by use of Mann-Whitney tests.
Results: Of NT scans, 100% showed Goutallier grade 0 or 1. Among FTT scans, 2 showed grade 0, 21 showed grade 1, 35 showed grade 2, 14 showed grade 3, and 76 showed grade 4. The difference was statistically significant (P < .001) between the Goutallier grade 3 and 4 scans, and the degree of Goutallier grade increased with increasing CTR (P < .001).
Conclusion: Fatty infiltration can be directly linked to CTR and, as such, may help to determine surgical intervention between groups.
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http://dx.doi.org/10.1016/j.jse.2011.09.019 | DOI Listing |
Neuromuscul Disord
November 2024
Department of Neurology, Neuroscience Faculty Center, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India. Electronic address:
Idiopathic inflammatory myopathies (IIMs) constitute a group of immune-mediated disorders, affecting muscles. Our study aims to investigate the specific patterns of muscle involvement in subgroups of IIM. An ambispective and observational study was conducted.
View Article and Find Full Text PDFN Am Spine Soc J
December 2024
Northwell Health Long Island Jewish Medical Center, Department of Orthopedic Surgery, 270-05 76th Avenue, Queens, NY 11040, United States.
Background: Prior studies have linked sarcopenia and fat infiltration in paraspinal muscles with lumbar pain, spinal pathology, and adverse postoperative outcomes in lumbar spine surgery. A recent magnetic resonance imaging (MRI)-based method for assessing muscle health, incorporating parameters such as Goutallier Classification (GC) and the Paralumbar Muscle Cross-Sectional Area to Body Mass Index ratio (PL-CSA/BMI), has shown that higher muscle grades correlate with significant improvements in patient-reported outcomes. Despite these advancements, there is limited research on the associations between paralumbar muscle health and factors such as age, BMI, walking tolerability, and spondylolisthesis.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia.
Purpose: To evaluate the minimum 12-month clinical and radiological outcomes of combined superior capsular reconstruction (SCR) and lower trapezius transfer (LTT) for posterosuperior irreparable massive rotator cuff tears (IMRCTs).
Methods: Patients with posterosuperior IMRCTs and severe fatty infiltration (Goutallier grades 3 or more) in the infraspinatus who underwent SCR +LTT were retrospectively reviewed. A double-folded fascia lata autograft with one layer of polypropylene mesh inside was used for SCR and an Achilles tendon allograft was used to connect the tendon of lower trapezius to the greater tuberosity.
Orthop J Sports Med
December 2024
Oregon Shoulder Institute, Medford, Oregon, USA.
Background: Despite the effectiveness of reverse total shoulder arthroplasty (RSA) and arthroscopic rotator cuff repair (ARCR) for treating massive rotator cuff tears (MRCTs), controversies remain in patients without glenohumeral osteoarthritis (GHOA).
Purpose: To compare clinical outcomes of ARCR or RSA in patients with MRCT with high-grade fatty atrophy without GHOA.
Study Design: Cohort study; Level of evidence, 3.
Massive rotator cuff tears are a challenge for patients and surgeons. We explored the outcomes of patients with massive rotator cuff tears primarily treated with primary cuff repair augmented with a subacromial balloon spacer. The mean age of the patients was 64.
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