Prediction of the Irreparability of Rotator Cuff Tears

What can the radiological parameters of superior migration of the humeral head tell us about the reparability of massive rotator cuff tears?

“…To evaluate whether any of these parameters of superior humeral migration may predict the reparability of massive rotator cuff tears, the tangent sign, the degree of tendon retraction, and fatty infiltration of the rotator cuff muscles were recorded and analyzed based on the results of previous studies [10,17,[24][25][26]. The tangent sign was considered positive if the bulk A-B Measurement of the superior humeral migration on anterior-posterior radiograph (A) and coronal magnetic resonance image (B).…”

“…Since the cut-off value for the reparability of massive rotator cuff tears in the Patte classification is grade 3, and those of the supraspinatus and infraspinatus fatty infiltrations were grade > 3 and grade > 2, respectively, in a previous study [25], we used theses cut-off values in our analysis. For the fatty infiltration of the subscapularis muscle, we distinguished between � grade 1 and >2 in reference to Kim et al [10].…”

“…However, few studies have investigated the relationship between these parameters of superior humeral migration on the one hand and their measurement with different imaging methods on the other hand. Furthermore, while some recent studies evaluated the utility of superior migration indexes as predictors of the reparability of rotator cuff tears [10,17,26,32], no study has done this comprehensively and exclusively for massive rotator cuff tears. The present study was focused on investigating the interrelationship between the superior humeral migration indexes AHI, IGHD, and UMI per se and when measured using different imaging modalities on the one hand, and their capability to predict the reparability of massive rotator cuff tears on the other hand.…”

“…In that study, the IGHD was not included as an independent predictor, because it was not significant when considered other factors. More recently, Kim et al [10] showed that the AHI measured on MR imaging was an independent predictor of irreparability in large-to-massive rotator cuff tears. Although the parameters of superior humeral migration were significantly different between the complete and partial repair group in our study, none of the indices of superior humeral migration was an independent predictor of irreparability in massive rotator cuff tear.…”

“…The AHI in the normal population has been reported to range from 7 to 14 mm [2,3,6]. A decreased AHI has been found to be associated with rotator cuff tears [3,7], full-thickness rotator cuff tears [8,9], massive rotator cuff tears [1,7], irreparability of rotator cuff tears [10], preoperative impairment of shoulder function [11], high retear rates after surgery [12][13][14], and fatty degeneration of the rotator cuff [9,15].…”