A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

Abstract

Background In 1990, Hamada et al. radiographically classified massive rotator cuff tears into five grades. Walch et al. subsequently subdivided Grade 4 to reflect the presence/absence of subacromial arthritis and emphasize glenohumeral arthritis as a characteristic of Grade 4. Questions/purposes We therefore determined (1) whether patient characteristics and MRI findings differed between the grades at initial examination and final followup; (2) which factors affected progression to a higher grade; (3) whether the retear rate of repaired tendons differed among the grades; and (4) whether the radiographic grades at final followup differed from those at initial examination among patients treated operatively. Patients and Methods We retrospectively reviewed 75 patients with massive rotator cuff tears. Thirty-four patients were treated nonoperatively and 41 operatively.

Options Before Reverse Total Shoulder Replacement

“…This distance, the acromiohumeral interval (AHI), measures 7-14 mm in healthy shoulders [24] and as previously mentioned if it falls below 7 mm, the probability of successful cuff repair drastically decreases [25]. Hamada et al [26] demonstrated correlation between progression of rotator cuff tear and reduction of AHI. He developed a radiographic classification of massive rotator cuff tear arthritis which divides massive rotator cuff tears into 5 grades: in Hamada Grade 1 the AHI is maintained, and narrows in Grade 2.…”

“…Acetabulization (concave deformity of the acromion undersurface) in addition to the Grade 2 narrowing is classified as Grade 3. In Grade 4, narrowing of the glenohumeral joint is added to the Grade 3 features, and Grade 5 comprises instances of humeral head collapse [26]. .…”

“…. These subtypes allowed for more specific classification of patients and almost all patients could be classified [26].…”

Rotary Hood Massive Break Solutions? Massive Rotator Cuff Tear Solutions?

“…Fat infiltration gains importance when clinical studies find that it is associated with a worse prognosis and higher postoperative failure rates [5,15]. The degree of fatty infiltration of the supraspinatus and infraspinatus seems to be related to a worse prognosis [4,16,17]. The degree of adipose infiltration in MRI is a strong predictive factor for recurrence of postoperative rupture [9].…”

“…It is also an asset in the evaluation of the competence of the coracoacromial arch [2]. The use of the Chest X-ray allowed the creation of the Hamada Radiological Classification in 1990, consisting of 5 stages that reflect the temporal evolution of rupture and a successive progression of arthropathy (Table 3) [16]. …”