Long-term functional and structural outcome in patients with intact repairs 1 year after open transosseous rotator cuff repair

Goutallier, D; Postel, J.-M.; Radier, C.; Bernageau, J; Zilber, S.

doi:10.1016/j.jse.2008.11.006

Cited by 71 publications

(42 citation statements)

References 18 publications

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“…The detection of soleus and gastrocnemius muscle abnormalities in patients with chronic Achilles tendon abnormalities may be of similar importance to rotator cuff therapy of the shoulder where the assessment of the muscle quality plays an important role in therapy decisionmaking among conservative treatment, tendon repair and tendon transfer [12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…Anatomical (direct suture of the torn tendons) and non-anatomical tendon-graft repairs are two main options. According to the rotator cuff surgery in the shoulder where the quality of the muscles is of great importance to the surgical outcome [12][13][14][15][16] more favourable outcome when the corresponding muscle does not show fatty degeneration. To our knowledge, little is known about the calf muscle changes in the presence of Achilles tendon abnormalities.…”

Section: Introductionmentioning

confidence: 99%

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Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

et al. 2011

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Objective The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Methods Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Results Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n=20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n=19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p=0.032 and p= 0.021, respectively). Conclusion Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

et al. 2011

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“…Although physical therapy has been shown to play an important role in the nonsurgical treatment 33,41,45 and postsurgical rehabilitation after rotator cuff repair, 7,38 previous research has shown that most gains in function and strength, and presumably the patient’s subjective assessment as well, will be realized within the first year after surgery. 22,57 Patients were encouraged to continue their home-based strengthening program, but it is unknown if they did or if activities of daily living were sufficient to maintain the strength levels that they had achieved by 12 months after surgery. It is certainly plausible that altered glenohumeral motion and strength deficits after rotator cuff repair are not a reflection of the surgical technique but rather a limitation in the postsurgical rehabilitation protocol.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

et al. 2011

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Background Surgical repair of a torn rotator cuff is based on the belief that repairing the tear is necessary to restore normal glenohumeral joint (GHJ) mechanics and achieve a satisfactory clinical outcome. Hypothesis Dynamic joint function is not completely restored by rotator cuff repair, thus compromising shoulder function and potentially leading to long-term disability. Study Design Controlled laboratory study and Case series; Level of evidence, 4. Methods Twenty-one rotator cuff patients and 35 control participants enrolled in the study. Biplane radiographic images were acquired bilaterally from each patient during coronal-plane abduction. Rotator cuff patients were tested at 3, 12, and 24 months after repair of a supraspinatus tendon tear. Control participants were tested once. Glenohumeral joint kinematics and joint contact patterns were accurately determined from the biplane radiographic images. Isometric shoulder strength and patient-reported outcomes were measured at each time point. Ultrasound imaging assessed rotator cuff integrity at 24 months after surgery. Results Twenty of 21 rotator cuff repairs appeared intact at 24 months after surgery. The humerus of the patients’ repaired shoulder was positioned more superiorly on the glenoid than both the patients’ contralateral shoulder and the dominant shoulder of control participants. Patient-reported outcomes improved significantly over time. Shoulder strength also increased over time, although strength deficits persisted at 24 months for most patients. Changes over time in GHJ mechanics were not detected for either the rotator cuff patients’ repaired or contralateral shoulders. Clinical outcome was associated with shoulder strength but not GHJ mechanics. Conclusion Surgical repair of an isolated supraspinatus tear may be sufficient to keep the torn rotator cuff intact and achieve satisfactory patient-reported outcomes, but GHJ mechanics and shoulder strength are not fully restored with current repair techniques. Clinical Relevance The study suggests that current surgical repair techniques may be effective for reducing pain but have not yet been optimized for restoring long-term shoulder function.

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“…Goutallier et al [15] reported functional Constant and Murley score and radiographic (MRI and/or CT scans) outcomes for 220 shoulders undergoing rotator cuff repair; the rate of recurrent tear was greater in patients with fatty infiltration of the muscle. A longer-term study by Goutallier et al [17] showed a strong correlation between the Constant and Murley score (a functional outcome score for the shoulder) at latest followup and preoperative fatty infiltration. In another study [10], preoperative fatty infiltration and muscle atrophy were found to be independent predictors for final American Shoulder and Elbow Surgeons and Constant and Murley scores after rotator cuff repair.…”

Section: Purposementioning

confidence: 97%

Classifications in Brief: Goutallier Classification of Fatty Infiltration of the Rotator Cuff Musculature

Somerson

Hsu

Gorbaty

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Long-term functional and structural outcome in patients with intact repairs 1 year after open transosseous rotator cuff repair

Cited by 71 publications

References 18 publications

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

Classifications in Brief: Goutallier Classification of Fatty Infiltration of the Rotator Cuff Musculature

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