Fatty Degeneration of the Rotator Cuff Reflects Shoulder Strength Deficits in Patients With Rotator Cuff Tears

Yoon, Jong Pil; Jung, Jin Tae; Lee, Chang Hwa; Kim, Young Gun; Chung, Seok Won; Kim, Joon Yub; Lee, Hyun Joo; Yoon, Jee Wook; Lee, Hoseok

doi:10.3928/01477447-20171106-02

Cited by 11 publications

(8 citation statements)

References 31 publications

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“…The validity of isokinetic testing for patients with RTC pathology is supported by the consistent finding of inverse correlations between peak torque and fatty degeneration in the rotator cuff [14,25,26,38]. The utility of isokinetic testing for detecting grades of RTC tears or partial tears is inconsistent [7,10,14,18,24,26,30].…”

Section: Resultsmentioning

confidence: 99%

Isokinetic testing of the shoulder rotator muscles of older individuals with shoulder pathology: An integrative review

Tudini¹

2020

IES

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BACKGROUND: Shoulder pathology is common, particularly in older adults. This pathology often involves the muscles of the shoulder, particularly those of the rotator cuff. Although there are many procedures for measuring muscle weakness and imbalance of the shoulder rotator muscles, isokinetic dynamometry is probably considered the gold standard. OBJECTIVE: To describe the use and findings of isokinetic testing of the shoulder rotator muscles in patients with shoulder disorders. METHODS: A PubMed search was performed using the string "isokinet* AND rotator cuff." Thereafter, a secondary hand search was conducted. Original articles that reported isokinetic measures of the shoulder rotators in older patients with orthopedic shoulder disorders were identified, summarized, and critically appraised. RESULTS: Thirty-four relevant articles were found. The articles largely support the validity, reliability, and responsiveness of isokinetic strength measures of shoulder rotation strength in patients with shoulder pathology. CONCLUSIONS: The literature provides support for the isokinetic measurement of rotator muscle performance in patients with shoulder pathology. However, it is not always practical in the clinical setting.

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Section: Resultsmentioning

confidence: 99%

Isokinetic testing of the shoulder rotator muscles of older individuals with shoulder pathology: An integrative review

Tudini¹

2020

IES

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“…In patients with rotator cuff tears, more severe muscle fatty degeneration is associated with shoulder strength deficits. 51 In other shoulder studies, Lapner et al 31 showed that a greater degree of preoperative fatty atrophy was negatively correlated with shoulder strength after shoulder arthroplasty. Sayed-Noor et al 44 demonstrated that greater preoperative rotator cuff FI and muscle atrophy were associated with reduced preoperative (and postoperative) strength in patients undergoing shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 95%

Association of Preoperative Gluteal Muscle Fatty Infiltration With Patient Outcomes in Women After Hip Abductor Tendon Repair Augmented With LARS

Ebert

Smith

Breidahl³

et al. 2019

Am J Sports Med

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Background: Hip abductor tendon repair has demonstrated encouraging outcomes. The influence of fatty infiltration (FI) on outcome has not been explored. Purpose: To investigate the association between preoperative hip abductor FI and clinical outcome after hip abductor tendon repair. Study Design: Case series; Level of evidence, 4. Methods: A total of 84 women underwent hip abductor tendon repair. The mean age was 64.6 years (range, 43-84 years); body mass index, 27.7 (range, 20.0-40.2); and duration of symptoms, 3.4 years (range, 6 months–20 years). The 6-minute walk test, isometric hip abduction strength assessment, and patient-reported outcome measures, including the Harris Hip Score and Oxford Hip Score, were completed presurgery and 2 years after surgery. Patient satisfaction and perceived improvement were assessed 2 years after surgery. All patients underwent preoperative magnetic resonance imaging on the affected hip, and the Goutallier system was used to grade the degree of FI in the anterior, middle, and posterior thirds of the gluteus medius and minimus on a 0-4 ordinal scale. A single FI score for the gluteus medius and minimus was calculated, as was a combined FI score. Results: All clinical scores significantly improved over time ( P < .001). Preoperatively, FI was more severe in the gluteus minimus, with the most severe FI (grades 2-4) demonstrated in the middle (n = 56, 66.7%) and anterior (n = 17, 20.2%) portions of the gluteus minimus and the middle (n = 27, 32.1%) and anterior (n = 12, 14.3%) portions of the gluteus medius. Older age was associated with greater FI (combined FI score: r = 0.529, P < .001), although duration of symptoms ( r = 0.035, P = .753) and body mass index ( r = 0.089, P = .464) were not. Greater FI was associated with less improvement in hip strength of the unaffected leg (coefficient, –1.6, 95% CI: −2.8 to −0.4), although no other significant associations were observed between FI and pre- or postoperative clinical scores. Conclusion: Preoperative FI was not associated with pertinent parameters of patient outcome after hip abductor tendon repair, including pain, symptoms, functional capacity, perceived improvement, and satisfaction. Based on these outcomes, surgical repair may be considered in the presence of more severe FI.

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“…Repetitive overhead throwing, which was performed in sports, may result in muscle imbalance between the ER and IRs [ 44 ]. The fatty degeneration of the rotator cuff muscle correlates with the isokinetic muscle strength deficit, but the tear extent was not reflected directly to it [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors

Son

Seo

Choi

et al. 2022

IJERPH

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With the aging society, musculoskeletal degenerative diseases are becoming a burden on society, and rotator cuff disease is one of these degenerative diseases. The purpose of this study was to examine the incidence of shoulder osteoarthritis and the etiologic factors of rotator cuff disease in the Korean elderly population. A total of 102 patients performing ultrasonography were recruited, and their demographic factors were analyzed. As functional factors, visual analog scale and the peak torque of external and internal rotators of the shoulder using an isokinetic dynamometer were measured. As an anatomical factor, the acromiohumeral distance in the plain radiograph of the glenohumeral anterior-posterior view was used. There were more female patients (65.7%) than male patients (34.3%). The age range with the highest number of respondents was 50–59 years old. The mean visual analogue score was 4.09 (Min 1 to Max 9). Age and dominant hand side factors appear to be the crucial etiologic factors of the presence and severity of rotator cuff disease. The lower net value of the external rotator strength is weakly related to the presence of rotator cuff disease after adjusting for age, and this is the only modifiable factor in the study.

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Fatty Degeneration of the Rotator Cuff Reflects Shoulder Strength Deficits in Patients With Rotator Cuff Tears

Cited by 11 publications

References 31 publications

Isokinetic testing of the shoulder rotator muscles of older individuals with shoulder pathology: An integrative review

Isokinetic testing of the shoulder rotator muscles of older individuals with shoulder pathology: An integrative review

Association of Preoperative Gluteal Muscle Fatty Infiltration With Patient Outcomes in Women After Hip Abductor Tendon Repair Augmented With LARS

Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors

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