Clin Orthop Surg.  2013 Mar;5(1):55-65. 10.4055/cios.2013.5.1.55.

Is the Supraspinatus Muscle Atrophy Truly Irreversible after Surgical Repair of Rotator Cuff Tears?

• Chung SW
• Kim SH
• Tae SK
• Yoon JP
• Choi JA
• Oh JH

• KMID: 1402327
• DOI: http://doi.org/10.4055/cios.2013.5.1.55

Abstract

BACKGROUND
Atrophy of rotator cuff muscles has been considered an irreversible phenomenon. The purpose of this study is to evaluate whether atrophy is truly irreversible after rotator cuff repair.
METHODS
We measured supraspinatus muscle atrophy of 191 patients with full-thickness rotator cuff tears on preoperative magnetic resonance imaging and postoperative multidetector computed tomography images, taken at least 1 year after operation. The occupation ratio was calculated using Photoshop CS3 software. We compared the change between pre- and postoperative occupation ratios after modifying the preoperative occupation ratio. In addition, possible relationship between various clinical factors and the change of atrophy, and between the change of atrophy and cuff integrity after surgical repair were evaluated.
RESULTS
The mean occupation ratio was significantly increased postoperatively from 0.44 +/- 0.17 to 0.52 +/- 0.17 (p < 0.001). Among 191 patients, 81 (42.4%) showed improvement of atrophy (more than a 10% increase in occupation ratio) and 33 (17.3%) worsening (more than a 10% decrease). Various clinical factors such as age tear size, or initial degree of atrophy did not affect the change of atrophy. However, the change of atrophy was related to repair integrity: cuff healing failure rate of 48.5% (16 of 33) in worsened atrophy; and 22.2% (18 of 81) in improved atrophy (p = 0.007).
CONCLUSIONS
The supraspinatus muscle atrophy as measured by occupation ratio could be improved postoperatively in case of successful cuff repair.

Keyword

Atrophy; Occupation ratio; Postoperative change; Rotator cuff

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multidetector Computed Tomography
Muscular Atrophy/*diagnosis
Recovery of Function
Retrospective Studies
Rotator Cuff/injuries/*surgery
Tendon Injuries/diagnosis/rehabilitation/*surgery

Figure

• 

  Fig. 1 The supraspinatus muscle atrophy was measured on the same oblique sagittal Y-view of magnetic resonance imaging (A) and multidetector computed tomography (B), where the body of the scapula, scapular spine, and medial border of the coracoids process form a Y-shape.

• 

  Fig. 2 The figure shows the calculation of the occupation ratio by dividing the area of the supraspinatus muscle (A) by that of the supraspinatus fossa (B), using Photoshop on multidetector computed tomography sagittal oblique image.

• 

  Fig. 3 The graph shows a very good correlation between the occupation ratio of magnetic resonance imaging (MRI) and that of multidetector computed tomography (MDCT), and Y = 0.03 + 0.98X (R2 = 0.76) was derived from the linear regression analysis. MRT1W: MR T1-weighted image.

• 

  Fig. 4 The figure is an example which shows an improvement of occupation ratio [from 0.28 (A) to 0.44 (B) in this case] one year after rotator cuff repair.

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