Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears

Goutallier, D; Postel, J.-M.; Gleyze, P.; Leguilloux, Pierre; Driessche, Stéphane Van

doi:10.1016/s1058-2746(03)00211-8

Cited by 866 publications

(687 citation statements)

References 4 publications

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“…This lack of balance puts the deltoid at a mechanical disadvantage, impairing the ability to raise the arm (pseudoparalysis). While rotator cuff repair techniques have advanced considerably in the last 10 years [10,19], irreparable tears, characterized by involvement of at least two tendons and fatty infiltration of the rotator cuff muscles, cannot be treated successfully using standard rotator cuff repair procedures [23,36,41]. An irreparable tear may allow migration of the humeral head and produce severe glenohumeral arthritis, which is the clinical entity known as CTA [5,15,18,21,40].…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of magnetic resonance imaging has allowed surgeons to evaluate the rotator cuff to determine size, retraction, and fatty infiltration staging based on the data by Goutallier et al [22]. It is currently much easier to determine if a rotator cuff tear will be irreparable or reparable based on MRI findings [23,36,41]. Large ([ 5 cm) tears that involve two or more rotator cuff tendons with atrophy and a high degree of fatty infiltration (stage 3 or 4) are unlikely to benefit from attempts at surgical repair [23,36,41].…”

Section: Introductionmentioning

confidence: 99%

“…It is currently much easier to determine if a rotator cuff tear will be irreparable or reparable based on MRI findings [23,36,41]. Large ([ 5 cm) tears that involve two or more rotator cuff tendons with atrophy and a high degree of fatty infiltration (stage 3 or 4) are unlikely to benefit from attempts at surgical repair [23,36,41]. Thus, we consider reparable tears to be those that have stage 0, 1 or 2 fatty infiltration [22,23].…”

Section: Introductionmentioning

confidence: 99%

“…Large ([ 5 cm) tears that involve two or more rotator cuff tendons with atrophy and a high degree of fatty infiltration (stage 3 or 4) are unlikely to benefit from attempts at surgical repair [23,36,41]. Thus, we consider reparable tears to be those that have stage 0, 1 or 2 fatty infiltration [22,23]. Interval slides and release of adhesions either arthroscopically or open are often indicated in retracted tears with minimal or no fatty infiltration of the associated musculature.…”

Section: Introductionmentioning

confidence: 99%

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Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

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Background Reverse total shoulder arthroplasty (RTSA) was introduced to treat rotator cuff tear arthropathy but is now used to treat a variety of problems. Although its use has expanded substantially since the FDA's approval in 2004, the appropriateness in patients with rotator cuff disease is unclear. Questions/purposes We review the use of RTSA in patients with rotator cuff disease to (1) describe classification of rotator cuff tear reparability and the concept of a balanced shoulder; (2) explore the theory behind RTSA design relative to rotator cuff arthropathy; (3) discuss the indications and contraindications for RTSA; and (4) review published outcomes of RTSA for rotator cuff arthropathy.Methods We performed a selective review of the literature on the use of RTSA in the treatment of rotator cuff disease.Results Modern RTSA designs restore deltoid tension and a functional fulcrum to the rotator cuff deficient shoulder, which allows recovery of active shoulder elevation and effectively restores function in short-and mediumterm followup studies. Conclusions In short-term followup the RTSA relieves symptoms and restores function for patients with cuff tear arthropathy and irreparable rotator cuff tears with pseudoparalysis (preserved deltoid contraction but loss of active elevation). Severely impaired deltoid function, an isolated supraspinatus tear, and the presence of full active shoulder elevation with a massive rotator cuff tear and arthritis are contraindications to RTSA. Clinical Relevance For properly selected patients who have symptomatic and disabling rotator cuff deficiency, RTSA can result in life-changing improvements in pain, motion, function, and patient satisfaction. Level of Evidence Level V therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

View full text Add to dashboard Cite

show abstract

“…The measured Goutallier grade can be used to estimate both retear rates and clinical outcomes following RC repairs, and thus give surgeons an indication as to tendon reparability and help to counsel patients regarding their likely outcomes. A study using both CT and MRI assessment of 220 shoulders found that a Goutallier grade of greater than 1 predicts higher retear rates for RC repairs (23). Postoperative American Shoulder and Elbow Surgeons and Constant scores also reportedly correlate with Goutallier grading (5,24).…”

Section: Clinical Relevance Of Fimentioning

confidence: 99%