Clin Should Elbow.  2018 Dec;21(4):207-212. 10.5397/cise.2018.21.4.207.

Comparison of Clinical and Anatomical Outcomes between Delaminated Rotator Cuff Tear and Single Layer Rotator Cuff Tear

Affiliations
  • 1Department of Orthopedic Surgery, Kangwon National University School of Medicine, Chuncheon, Korea. luteus@naver.com

Abstract

BACKGROUND
Delaminated rotator cuff tear is known to be a degenerative tear having a negative prognostic effect. This study undertook to compare the anatomical and clinical outcomes of delaminated tears and single layer tears.
METHODS
Totally, 175 patients with medium to large rotator cuff tears enrolled for the study were divided into 2 groups, based on the tear pathology: single layer tear (group 1) and delaminated tear (group 2). Preoperatively, length of the remnant tendon, muscle atrophy of supraspinatus (SS), and fatty degeneration of SS and infraspinatus (IS) muscles were assessed on magnetic resonance imaging (MRI). For follow-up, the repair integrity of the rotator cuff was evaluated by ultrasonography. Clinical outcomes were assessed by evaluating the Constant score (CS) and Korean Shoulder Score (KSS).
RESULTS
Retears were detected in 6 cases of group 1 (6.5%) and 11 cases of group 2 (13.3%). Although higher in group 2, the retear rate was significantly not different (p=0.133). Preoperative MRI revealed length of remnant tendon to be 15.46 ± 3.60 mm and 14.17 ± 3.16 mm (p=0.013), and muscle atrophy of SS (occupation ratio) was 60.54 ± 13.15 and 56.55 ± 12.88 (p=0.045), in group 1 and group 2, respectively. Fatty degeneration of SS and IS in both groups had no significant differences. Postoperatively, no significant differences were observed for CS and KSS values between the groups.
CONCLUSIONS
Delaminated rotator cuff tears showed shorter remnant tendon length and higher muscle atrophy that correlate to a negative prognosis. These prognostic effects should be considered during delaminated rotator cuff tear treatment.

Keyword

Shoulder; Rotator cuff tears; Delaminated tear; Whole layer repair; Retear

MeSH Terms

Follow-Up Studies
Humans
Magnetic Resonance Imaging
Muscles
Muscular Atrophy
Pathology
Prognosis
Rotator Cuff*
Shoulder
Tears*
Tendons
Ultrasonography
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