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. 2022 Jul;142(7):1395-1403.
doi: 10.1007/s00402-021-03765-8. Epub 2021 Jan 23.

Three-dimensional quantitative measurements of atrophy and fat infiltration in sub-regions of the supraspinatus muscle show heterogeneous distributions: a cadaveric study

Jose H Trevino Iii  1 , Takuma Yuri  1   2 , Taku Hatta  3 , Yoshiro Kiyoshige  2 , Philip M Jacobs  4 , Hugo Giambini  5   6
Affiliations

Three-dimensional quantitative measurements of atrophy and fat infiltration in sub-regions of the supraspinatus muscle show heterogeneous distributions: a cadaveric study

Jose H Trevino Iii et al. Arch Orthop Trauma Surg. 2022 Jul.

Abstract

Introduction: Rotator cuff tears are common in the older population. Atrophy and fat infiltration develop un-evenly in torn supraspinatus (SSP) muscles leading to pre- and post-surgical complications. The purpose of the current study was twofold: first, to implement a volumetric and quantitative magnetic resonance imaging (MRI) approach to quantify the degree of muscle atrophy and fat infiltration within the SSP muscle and its four sub-regions (AS, PS, AD, and PD); second to compare 3-D MRI outcomes to the standard 2-D assessment and investigate their relationship with tear size.

Materials and methods: Fifteen cadaveric shoulders were obtained and MRI performed. Quantitative 3-D outcomes included SSP muscle volume, fossa volume, fat-free muscle volume, and fat fraction for the whole SSP muscle and its four sub-regions. 2-D and qualitative measurements included tear size, 2-D fat infiltration using the Goutallier classification, tangent sign, and occupation ratio.

Results: Linear regression outcomes with tear size were not significant for both cross-sectional area (r = - 0.494, p = 0.061) and occupation ratio (r = - 0.011, p = 0.969). Tear size negatively correlated with fat-free muscle volume for both AS and PS sub-regions (AS: r = - 0.78, p < 0.001; PS: r = - 0.68, p = 0.005, respectively) while showing no significant correlation with fat fraction outcomes. AD and PD sub-regions positively correlated with tear size and fat fraction outcomes (AD: r = 0.70, p = 0.017; PD: r = 0.52, p = 0.045, respectively), while no significant correlation was observed between tear size and fat-free muscle volumes.

Conclusion: Quantitative 3-D volumetric assessment of muscle degeneration resulted in better outcomes compared to the standard 2-D evaluation. The superficial supraspinatus muscle sub-regions primarily presented muscle atrophy, while the deep sub-regions were mainly affected by fat infiltration. 3-D assessments could be used pre-surgically to determine the best course of treatment and to estimate the muscles' regenerative capacity and function.

Keywords: Atrophy; Fat infiltration; Goutallier classification; Muscle sub-region; Occupation ratio; Rotator cuff tear.

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References

    1. Chung SW, Kim JY, Kim MH, Kim SH, Oh JH (2013) Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors associated with healing failure or poor postoperative function. Am J Sports Med 41(7):1674–1683 - DOI
    1. Fabis J, Danilewicz M, Omulecka A (2001) Rabbit supraspinatus tendon detachment: effects of size and time after tenotomy on morphometric changes in the muscle. Acta Orthop Scand 72(3):282–286 - DOI
    1. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8(6):599–605 - DOI
    1. Fukuta S, Tsutsui T, Amari R, Wada K, Sairyo K (2016) Tendon retraction with rotator cuff tear causes a decrease in cross-sectional area of the supraspinatus muscle on magnetic resonance imaging. J Shoulder Elbow Surg 25(7):1069–1075 - DOI
    1. Gerber C, Schneeberger AG, Hoppeler H, Meyer DC (2007) Correlation of atrophy and fatty infiltration on strength and integrity of rotator cuff repairs: a study in thirteen patients. J Shoulder Elbow Surg 16(6):691–696 - DOI

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