• Investigative Magnetic Resonance Imaging
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• v.20 no.4
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• pp.224-230
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• 2016

Purpose: The purpose of this study was to compare the grade of fatty degeneration and atrophy of rotator cuffs on immediate postoperative MRI to those on preoperative MRI in patients with rotator cuff tears. Materials and Methods: Seventy patients were included in this study, who received arthroscopic rotator-cuff repair and underwent both preoperative magnetic resonance imaging (MRI) and immediate postoperative MRI in our institution. Fatty degeneration of rotator cuffs and the atrophy of supraspinatus muscles were evaluated with T1 oblique sagittal images in the Y-shaped view. Fatty degeneration was evaluated using a Goutallier classification system, and the atrophy of supraspinatus muscles was evaluated using a modified tangent sign and a visual occupation ratio. Results: From 70 patients, a total of 100 tendons were repaired: 18, 69, and 13 tendons were treated for subscapularis, supraspinatus, and infraspinatus, respectively. The Goutallier grades (P = 0.012), modified tangent signs (P = 0.000), and visual occupation ratios (P = 0.000) of supraspinatus muscles were significantly decreased in immediate postoperative MRIs when compared to preoperative MRIs. In immediate postoperative MRIs, the Goutallier grades of supraspinatus muscles were decreased by one grade in 18.8% (n = 13) of the patients, and the atrophy of supraspinatus muscles was improved by one grade in 26.1% (n = 18) for modified tangent signs and 21.7% (n = 15) for visual occupation ratios. However, fatty infiltration by the Goutallier grades of subscapularis (P = 1.000) and infraspinatus (P = 0.157) muscles were not significantly changed after arthroscopic surgery. Conclusion: Immediate postoperative MRIs showed a significant improvement of fatty degeneration and muscle atrophy in supraspinatus muscles when compared to preoperative MRIs.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.203-209
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• 2019

Background: Clinical outcomes and prognosis of large and massive rotator cuff tears are known to be unpredictable not only in degeneration of the rotator cuff, but also due to a high rate of retear. Methods: Totally, 81 patients who had undergone arthroscopic rotator cuff repair from May 2008 to February 2016 were evaluated in our study. Clinical and functional evaluations were performed with the Constant score and the University of California, Los Angeles (UCLA) score, as well as full physical examination of the shoulder. All patients were confirmed to have magnetic resonance imaging (MRI) of tendon healing at least 1 year postoperatively. Results: The average age at the time of surgery was 65 years (range, 47-78 years). The average duration of postoperative time in which a follow-up MRI was performed was 36.1 months (range, 12-110 months). Large tears were present in 48 cases (59.3%) and massive tears in 33 cases (40.7%). Overall, there were 33 retear cases (40.7%). All the average clinical outcome scores were significantly improved at the last follow-up (p<0.001), although repair integrity was not maintained. Compared to type A, types C, and D of the Collin's classification showed significantly higher retear rates (p=0.036). Conclusions: Arthroscopic rotator cuff repair yields improved clinical outcomes and a relatively high degree of patient satisfaction, despite the repair integrity not being maintained. Involvement of the subscapularis muscle or infraspinatus muscle had no effect on the retear rate.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.45-48
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• 2013

A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.