Purpose
To investigate whether and how arthroscopic rotator cuff repair changes the appearance
of fatty infiltration and muscle atrophy as shown on magnetic resonance imaging (MRI)
by comparing measurements taken before and immediately after surgery.
Methods
The first study determined appropriate measurements of fatty infiltration and muscle
atrophy, and the second study assessed immediate postoperative changes caused by surgery
per se. Forty-two patients who underwent arthroscopic shoulder surgery for reasons
other than rotator cuff repair were included in the first study, and 101 patients
who underwent arthroscopic rotator cuff repair were included in the second study.
MRI was undertaken preoperatively and 3 days after surgery. Fatty infiltration was
evaluated with the Goutallier grade and by measuring signal intensities of rotator
cuff muscles, and muscle atrophy was assessed with the tangent sign, occupation ratio,
and cross-sectional areas of muscles.
Results
In the first study, only the cross-sectional area of the subscapularis significantly
changed after surgery and was excluded in the second study. In the second study, fatty
infiltration seemingly improved by at least 1 grade in 50.0%, 75.0%, and 95.8% of
patients with Goutallier grade 2, 3, and 4, respectively, in the supraspinatus (P < .001) and in 28.6%, 57.1%, and 66.7%, respectively, in the infraspinatus (P < .001). Muscle atrophy of the supraspinatus changed by at least 1 grade in 93.6%
of patients with a grade 2 tangent sign and 100.0% with a grade 3 tangent sign, as
well as 84.0% of patients with a grade 3 occupation ratio; cross-sectional areas of
the supraspinatus and infraspinatus significantly increased by 21.6% and 7.0%, respectively
(all P < .001).
Conclusions
This study showed that arthroscopic rotator cuff repair changed the appearance of
both fatty infiltration and muscle atrophy of the supraspinatus and infraspinatus
on MRI. We suggest that these changes be considered when one is assessing rotator
cuff muscle changes by comparing the appearance on MRI before surgery with that at
a certain time after surgery.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: January 10, 2013
Accepted:
October 10,
2012
Received:
February 14,
2012
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
