Prognostic influence of fatty infiltration on rotator cuff repair

摘要

This study aimed to investigate the influence of preoperative supraspinatus and infraspinatus fatty infiltration on postoperative shoulder function recovery and analyze the relationship between preoperative supraspinatus and infraspinatus fatty infiltration and the retear rate after isolated supraspinatus full-thickness tear repair. Retrospective cohort study of 56 cases was carried out between 2005 and 2007 in the Department of Sports Medicine of Huashan Hospital. According to the degree of preoperative supraspinatus and infraspinatus fatty infiltration, we divided 26 cases in Group A (supraspinatus Grade 0-1 and infraspinatus Grade 0-1), 0 case in Group B (supraspinatus Grade 0-1 and infraspinatus Grade≥ 2), 11 cases in Group C (supraspinatus Grade ≥ 2 and infraspinatus Grade 0-1), and 19 cases in Group D (supraspinatus Grade ≥ 2 and infraspinatus Grade ≥ 2). Follow-up data included shoulder abduction and external rotation, postoperative MRI of the rotator cuff integrity and fatty infiltration degree, active visual analogue scale (VAS) pain score, University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) shoulder function score. The postoperative VAS pain score, UCLA shoulder score, and ASES shoulder function score improved significantly in all patients (P&0.01). The postoperative ASES shoulder function score was obviously higher in Group A than Groups C and D (P&0.01), while it was obviously higher in Group C than Group D (P&0.01). The postoperative movement range and strength of external rotation was significantly different in Group D than Groups A and C (P&0.01). Retear were found in 7 patients by MRI (12.5%). The retear rate was significantly higher in Groups C and D than Group A (P&0.01), and it seemed to be much higher in Group D than Group C (P&0.01). Both preoperative supraspinatus and infraspinatus fatty infiltration are negatively correlated with the ASES shoulderfunction score. The shoulder external rotation movement is highly correlated with the infraspinatus fatty infiltration. The fatty infiltration is one of the important factors which affect the integrity of rotator repair. Even the infraspinatus fatty infiltration has a negative impact on isolated supraspinatus full-thickness tear. Caution should be taken over the infraspinatus fatty infiltration for the management of isolated supraspinatus tear.