Fatty Muscle Infiltration in Cuff Tear: Pre and Post Operative Evaluation by Mri

Abstract

Objective: To evaluate the fatty infiltration and atrophy of the supraespinatus in the pre- and postoperative of a rotator cuff lesion (RCL), by MRI. Methods: Ten patients with full-thickness rotator cuff tears who had undergone surgical arthroscopic rotator cuff repair between September and December 2011 were included. This is a prospective study, with analysis and comparison of fatty infiltration and atrophy of the supraespinatus. The occupation ratio was measured using the magic selection tool in Adobe Photoshop CS3(r) on T1 oblique sagittal Y-view MRI. Through Photoshop, the proportion occupied by the muscle belly regarding its fossae was calculated. Results: There was a statistically significant increase in the muscle ratio (p=0.013) comparing images pre and postoperative, analyzed by the Wilcoxon T test. Conclusion: The proportion of the supraspinal muscle above the pit increases in the immediate postoperative period, probably due to the traction exerted on the tendon at the time of repair. Level of Evidence II, Cohort Study.

Influence of adiponectin and inflammatory cytokines in fatty degenerative atrophic muscle

“…Reportedly, muscle atrophy accompanied by the fatty degeneration of muscles is clinically observed after nerve injury or tendon rupture 4 . However, despite recent improvements in nerve and tendon repair techniques, chronic inflammation and muscle atrophy associated with fatty degeneration still limit postoperative function 6 , 14 . Muscle atrophy occurs when the breakdown of proteins in muscle cells exceeds their synthesis, resulting in a decrease in muscle mass 15 , and reportedly, inflammatory cytokines and oxidative stress enhance this muscle degradation process.…”

Reassessment of Fatty Infiltration by Magnetic Resonance Ten Years After Rotator Cuff Injury Repair

“…( 3 )-( 5 Both muscle atrophy and fatty infiltration have a substantial influence on the clinical results of rotator cuff repair and on the re-rotation rate, and therefore interfere with management. ( 5 ),( 6 …”

“…( 10 )-( 12 One hypothesis about this divergence is that there is an immediate decrease in the proportion of fat (in addition to an increase in the occupancy of the muscle in its fossa) soon after surgical repair. This is probably due to the traction exerted on the tendon at the time of its repair 6 ),( 13 since the muscle-tendon unit is pulled in the coronal plane of the scapula and the evaluation is usually performed in a fixed sagittal plane perpendicular to that of the traction. ( 14 …”

“…Precisely to study this hypothesis, in a previous study 6 we evaluated degenerative changes in the muscles of the supraspinatus comparing preoperative and immediate postoperative (POi) magnetic resonance imaging (MRI) scans of ten patients subjected to repair of rotator cuff injury, and concluded that there is an immediate increase in the muscle occupancy of the supraspinatus in its fossa.…”

Woven collagen biotextiles enable mechanically functional rotator cuff tendon regeneration during repair of segmental tendon defects in vivo

“…As a consequence, repairs of full‐thickness rotator cuff tears classified as large or massive fail on a regular basis and require revision surgery. Moreover, soft tissue degeneration is prevalent following rotator cuff tendon repair, occurring predominantly by way of fatty infiltration of the injured tendon and associated musculature, further impairing restoration of normal biomechanical function and resulting in inferior functional outcomes . As such, repairs of large to massive rotator cuff tendon tears remain suboptimal, despite continued advancements in surgical techniques and instrumentation …”