The teres minor muscle in rotator cuff tendon tears

Mélis, Barbara; DeFranco, Michael J.; Lädermann, Alexandre; Barthélemy, R; Walch, Gilles

doi:10.1007/s00256-011-1178-3

Cited by 69 publications

(43 citation statements)

References 18 publications

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“…Our findings are limited to patients with a massive rotator cuff tear without glenohumeral arthritis. However, teres minor insufficiency mostly is seen with massive rotator cuff tears as an isolated lesion of the teres minor (only seen in case of quadrilateral space syndrome, congenital absence, or muscle agenesis) [15,18]. We used CT arthrograms as the comparison to the clinical studies, but there are inaccuracies in the assessment of teres minor tears by CT, and we did not compare the findings with actual tears documented during surgery in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…We used CT arthrograms as the comparison to the clinical studies, but there are inaccuracies in the assessment of teres minor tears by CT, and we did not compare the findings with actual tears documented during surgery in these patients. We chose CT rather than MRI because (1) during the period of this study, it was a more-accessible examination method in our country, (2) fatty infiltration has been reliably determined through this method of imaging [18], and (3) Goutallier et al [11] classified muscle quality by the amount of fatty infiltration in the rotator cuff muscle as identified on CT in the axial plane, with a thorough analysis of the whole muscle belly. With the advent of MRI, however, the classification was extrapolated to the most lateral parasagittal image on which the scapular spine was in contact with the scapular body (Y view) [7].…”

Section: Discussionmentioning

confidence: 99%

“…The latter is related to musclotendinous retraction frequently seen in massive rotator cuff tears. As a result, a normal muscle can be interpreted as completely fatty infiltrated if such MRI criteria are used, and there is no proof that MR images compared with CT scans allowed a better analysis of posterosuperior retracted muscles of the rotator cuff [18]. Moreover, discrepancies regarding analysis of clinical tests by the two surgeons (PC and GW) needed to be discussed in seven cases to attain mutual agreement.…”

Section: Discussionmentioning

confidence: 99%

“…As teres minor rupture is difficult to determine, CT arthrograms were analyzed for fatty infiltration of the rotator cuff greater than Grade 3 as viewed in the sagittal plane (Fig. 4) [11,18,27]. Peripheral fatty tissue surrounding the muscles was viewed as extramuscular and was not taken into account.…”

Section: Radiographic Evaluation and Study Definitionsmentioning

confidence: 99%

“…However, evidence suggests that its integrity may be one of the most important variables affecting the outcome of reverse shoulder arthroplasty for massive rotator cuff tears [10,22]. The functional effects on day-to-day activities can be important [4,18,20], and previous research [5] has shown that teres minor integrity affects the outcomes of tendon transfers in massive rotator cuff tears.…”

Section: Introductionmentioning

confidence: 99%

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What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Treseder

Denard

Neyton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Few studies define the clinical signs to evaluate the integrity of teres minor in patients with massive rotator cuff tears. CT and MRI, with or without an arthrogram, can be limited by image quality, soft tissue density, motion artifact, and interobserver reliability. Additionally, the ill-defined junction between the infraspinatus and teres minor and the larger muscle-totendon ratio of the teres minor can contribute to error. Therefore, we wished to determine the validity of clinical testing for teres minor tears.Question/Purposes The aim of this study was to determine the accuracy of commonly used clinical signs (external rotation lag sign, drop sign, and the Patte test) for diagnosing the teres minor's integrity. Methods We performed a prospective evaluation of patients referred to our shoulder clinic for massive rotator cuff tears determined by CT arthrograms. The posterosuperior rotator cuff was examined clinically and correlated with CT arthrograms. We assessed interobserver reliability for CT assessment and used three different clinical tests of teres minor function (the external rotation lag sign, dropOne of the authors certifies that he (PC), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount less than USD 10,000 from Storz (Guyancourt, France), and an amount of USD 10,000-USD 100,000 from Tornier (Montbonnot, France). One of the authors certifies that he (GW), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,001 to USD 1,000,000 from Tornier (Montbonnot, France). One of the authors certifies that he (PJD), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 from Arthrex (Naples, FL, USA). One of the authors certifies that he (LN), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USA 10,000 to USD 100,000 from Tornier (Montbonnet, France). 123Clin Orthop Relat Res (2015) 473:2959-2966 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® sign, and the Patte test). One hundred patients with a mean age of 68 years were available for the analysis. Results The most accurate test for teres minor dysfunction was an external rotation lag sign greater than 40°, which had a sensitivity of 100% (95% CI, 80%-100%) and a specificity of 92% (95% CI, 84%-96%). External rotation lag signs greater than 10°had a sensitivity of 100% (95% CI, 80%-100%) and a specificity of 51% (95% CI, 40%-61%). The Patte sign had a sensitivity of 93% (95% CI, 70%-99%) and a specificity of 72% (95% CI, 61%-80%). The drop sign had a sensitivity of 87% (95% CI, 62%-96%) and a specificity of 88% (95% CI, 80%-

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Radiographic Evaluation and Study Definitionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Treseder

Denard

Neyton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder

Strakowski

Visco

2019

Muscle and Nerve

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High frequency ultrasound is a valuable tool for assessing soft tissue injuries about the shoulder. It has advantages over other imaging modalities including relatively low cost, portability, and dynamic real‐time visualization. It has a high sensitivity for identifying tendon degeneration, bursitis, and rotator cuff tears. Ultrasound is also an excellent modality for diagnostic and therapeutic needle‐guided procedures. A detailed knowledge of shoulder anatomy and transducer positioning is required for obtaining adequate diagnostic value from ultrasound. This Monograph is designed to help develop scanning protocols for optimizing image acquisition for musculoskeletal assessment of the shoulder. Muscle Nerve, 2019

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Massive Irreparable Rotator Cuff Tears: How to Rebalance the Cuff-Deficient Shoulder?

Boileau¹,

McClelland

Rumian

2015

Reverse Shoulder Arthroplasty

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The teres minor muscle in rotator cuff tendon tears

Abstract: The teres minor was normal in most rotator cuff tears. A morphologic classification system allowed the appearance of the teres minor to be defined in isolated and multiple rotator cuff tears in CT and MRI images.

Cited by 69 publications

References 18 publications

What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder

Massive Irreparable Rotator Cuff Tears: How to Rebalance the Cuff-Deficient Shoulder?

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