Role of fatty infiltration in the pathophysiology and outcomes of rotator cuff tears

Chaudhury, Salma; Dines, Joshua S.; Delos, Demetris; Warren, Russell F.; Voigt, Clifford; Rodeo, Scott A.

doi:10.1002/acr.20552

Cited by 40 publications

(25 citation statements)

References 30 publications

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“…Although the clinical effects of muscle fibrosis on RC injuries are not well quantified, muscle fibrosis is an important contributor to muscle stiffness and is seen in many other muscle injury models . Moreover, these changes have been shown to be irreversible even after RC repair …”

Section: Muscular Degenerationmentioning

confidence: 99%

“…32 Moreover, these changes have been shown to be irreversible even after RC repair. 33 Taking a deeper look into these changes, Barry et al showed that fatty infiltration and muscle atrophy are two different processes that are independently related to tears of the SS tendon. Fatty infiltration is also related to increasing age, tear severity, and sex, whereas muscle atrophy is related to increasing age but not tear severity.…”

Section: Muscular Degenerationmentioning

confidence: 99%

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Animal models for rotator cuff repair

Lebaschi

Deng

Zong

et al. 2016

Annals of the New York Academy of Sciences

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Rotator cuff (RC) injuries represent a significant source of pain, functional impairment, and morbidity. The large disease burden of RC pathologies necessitates rapid development of research methodologies to treat these conditions. Given their ability to model anatomic, biomechanical, cellular, and molecular aspects of the human RC, animal models have played an indispensable role in reducing injury burden and advancing this field of research for many years. The development of animal models in the musculoskeletal (MSK) research arena is uniquely different from that in other fields in that the similarity of macrostructures and functions is as critical to replicate as cellular and molecular functions. Traditionally, larger animals have been used because of their anatomic similarity to humans and the ease of carrying out realistic surgical procedures. However, refinement of current molecular methods, introduction of novel research tools, and advancements in microsurgical techniques have increased the applicability of small animal models in MSK research. In this paper, we review RC animal models and emphasize a murine model that may serve as a valuable instrument for future RC tendon repair investigations.

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Section: Muscular Degenerationmentioning

confidence: 99%

Section: Muscular Degenerationmentioning

confidence: 99%

Animal models for rotator cuff repair

Lebaschi

Deng

Zong

et al. 2016

Annals of the New York Academy of Sciences

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“…Although these parameters are widely translated into the clinical routine of cuff tear treatment, their reported predictive strengths are moderate‐to‐weak and, therefore, still controversially discussed in the current literature. Due to the in part controversial results in terms of tendon integration and functional outcome after tendon repair, there is an ongoing demand for improved and stronger outcome predictors after cuff repair to further assist the surgeon in a better prediction of tendon integration in case of a planned tendon repair.…”

mentioning

confidence: 99%

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Kamtchouing

Mick

Groß

et al. 2019

Journal Orthopaedic Research

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Supraspinatus (SSP) tendon tears represent a common indication for shoulder surgery. Yet, prediction of postoperative function and tendon retear remains challenging and primarily relies on morphologic magnetic resonance imaging (MRI)-based parameters, supported by patients' demographic data like age, gender, and comorbidities. Considering continuously high retear rates, especially in patients with larger tears and negative prognostic factors, improved outcome prediction could be of high clinical value. Contrastenhanced ultrasound (CEUS) enables an assessment of dynamic perfusion of the SSP muscle. As a potential surrogate for muscle vitality, CEUS might reflect functional properties of the SSP and support improved outcome prediction after tendon repair. Fifty patients with isolated SSP tendon tears were prospectively enrolled. Preoperatively, SSP muscle perfusion was quantified by CEUS and conventional morphologic parameters like tear size, fatty infiltration, and tendon retraction were assessed by MRI. At six months follow-up, shoulder function, tendon integrity, and muscle perfusion were reassessed. The predictive value of preoperative CEUS for postoperative shoulder function and tendon integrity was evaluated. 35 patients entered the statistical analysis. Preoperative CEUS-based assessment of SSP perfusion significantly correlated with early postoperative shoulder function (Constant, r = 0.48, p < 0.018) and tendon retear (r = 0.67, p < 0.001). CEUS-based subgroup analysis identified patients with exceptionally high, respectively low risk for tendon retear. CEUSbased assessment of the SSP seemed to predict early shoulder function and tendon retear after SSP repair and allowed to identify patient subgroups with exceptionally high or low risk for tendon retear.

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“…8 Kim et al 9 demonstrated that fatty infiltration of the rotator cuff muscles in rats correlated with both tear size and the presence of a suprascapular nerve neurotomy. 8 Kim et al 9 demonstrated that fatty infiltration of the rotator cuff muscles in rats correlated with both tear size and the presence of a suprascapular nerve neurotomy.…”

Section: Fatty Infiltration Mediated Impairment Of Healingmentioning

confidence: 99%

Healing of the rotator cuff

Chaudhury

Rodeo

2012

Current Orthopaedic Practice

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Increasing interest in biological and tissue engineering approaches to improving rotator cuff healing has been motivated by the relatively high failure rates after rotator cuff repairs. A number of recent studies have offered improved understanding of the pathophysiologic processes that contribute to the development of rotator cuff tears and have identified a number of treatment targets. While a number of in-vitro and animal studies have reported promising results for enhancing rotator cuff healing, few studies have demonstrated clinical efficacy. Optimizing the dose, timing and delivery method for therapies to modulate the biological or mechanical environment of the rotator cuff may be the key determinant of ultimate clinical success. Platelet Rich Plasma (PRP)Rather than isolating and delivering isolated growth factors, PRP aims to locally deliver cytokine levels that are at least 3--5 times the baseline concentration. Despite increasing interest and usage, there are limited level I studies to support its use; a number of clinical studies over the past year have questioned its efficacy in the rotator cuff.

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Role of fatty infiltration in the pathophysiology and outcomes of rotator cuff tears

Cited by 40 publications

References 30 publications

Animal models for rotator cuff repair

Animal models for rotator cuff repair

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Healing of the rotator cuff

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