Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2009 Oct;44(5):556-564. Korean.
    Published online Sep 23, 2009.
    https://doi.org/10.4055/jkoa.2009.44.5.556
    Copyright © 2009 The Korean Orthopaedic Association
    Original Article

    Analysis of the Change in Fatty Degeneration of the Rotator Cuff and Its Influence on the Outcome of Rotator Cuff Repair

    Jung-Suk Song, M.D., Jae-Myeung Chun, M.D., Jae-Bum Park, M.D., Se-Jun Chung, M.D. and Tae-Han Kim, M.D.
      • Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
    • Correspondence to Jae-Bum Park, M.D. Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82.2-3010-3530, Fax: +82.2-488-7877, Email: jbpark2@gmail.com
    Received June 10, 2009; Accepted August 25, 2009.

    Abstract

    Purpose

    To analyze the changes in fatty degeneration of the rotator cuff after its repair as well as the effect of fatty degeneration on the functional and anatomical outcomes.

    Materials and Methods

    The medical records of 107 patients (mean age=58.7 years), who had undergone a repair of rotator cuff tears, were reviewed. The mean follow-up period was 16 months. The following parameters were evaluated: the functional outcomes, including the American shoulder and elbow surgeons (ASES) score, Constant score and muscle power; preoperative and postoperative fatty degeneration of the rotator cuffs, including supraspinatus, infraspinatus and subscapularis; and the cuff integrity.

    Results

    Both the ASES and Constant scores were improved significantly postoperatively. The re-tear rate was 19.6%. The overall rate of satisfactory results was 88.8%. Fatty degeneration progressed in 25 cases (22.4%) and regressed in three (2.8%). More progression was observed in older (p=0.016) and re-tear (p=0.011) patients. The ASES score had a significant relationship with the preoperative fatty degeneration of the supraspinatus and the infraspinatus, whereas the Constant score was associated with the fatty degeneration of all three muscles.

    Conclusion

    Greater progression of fatty degeneration was observed in older and re-tear patients. The functional outcomes were better in the less severe fatty degeneration group.

    Keywords
    Rotator cuff tear; Fatty degeneration; Repair of rotator cuff

    Figures

    Fig. 1
    Regressed fatty degeneration of the infraspinatus in 63-years old woman. (A) Preoperative oblique sagittal image shows grade 2 fatty degeneration in the upper part of the infraspinatus with mild muscle atrophy. (B) Postoperative image shows regression to grade 1.

    Tables

    Table 1
    Preoperative and Postoperative Functional Outcomes

    Table 2
    Preoperative and Postoperative Fatty Degeneration

    Table 3
    Three Cases of Regression of Fatty Degeneration of the Rotator Cuffs

    Table 4
    Changes of Fatty Degeneration according to the Age

    Table 5
    Changes of the Fatty Degeneration according to the Anatomical Continuity of the Cuff

    Table 6
    Relationship between the Fatty Degeneration and Functional Outcomes

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    MeSH Terms
    Elbow
    Follow-Up Studies
    Humans
    Medical Records
    Muscles
    Rotator Cuff
    Shoulder
    Metrics
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