Abstract
Background: Management of massive chronic rotator cuff tears remains controversial, with no clearly defined clinical presentation as yet. The purpose of the study was to evaluate the effect of tear size and location on active motion in patients with chronic and massive rotator cuff tears with severe muscle degeneration. Methods: One hundred patients with massive rotator cuff tears accompanied by muscle fatty infiltration beyond Goutallier stage 3 were prospectively included in this study. All patients were divided into 5 groups on the basis of tear pattern (supraspinatus, superior subscapularis, inferior subscapularis, infraspinatus, and teres minor). Active range of shoulder motion was assessed in each group and differences were analyzed. Results: Active elevation was significantly decreased in patients with 3 tear patterns involved. Pseudoparalysis was found in 80% of the cases with supraspinatus and complete subscapularis tears and in 45% of the cases with tears involving the supraspinatus, infraspinatus, and superior subscapularis. Loss of active external rotation was related to tears involving the infraspinatus and teres minor; loss of active internal rotation was related to tears of the subscapularis. Conclusions: This study revealed that dysfunction of the entire subscapularis and supraspinatus or 3 rotator cuff muscles is a risk factor for pseudoparalysis. For function to be preserved in patients with massive chronic rotator cuff tears, it may be important to avoid fatty infiltration with anterior extension into the lower subscapularis or involvement of more than 2 rotator cuff muscles.
| Original language | English |
|---|---|
| Pages (from-to) | 1195-1202 |
| Number of pages | 8 |
| Journal | Journal of Shoulder and Elbow Surgery |
| Volume | 23 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2014 |
Fingerprint
Keywords
- Active range of motion
- Classification
- Massive rotator cuff tear
- Pseudoparalysis
- Shoulder
- Subscapularis tear
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
- Medicine(all)
Cite this
Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. / Collin, Philippe; Matsumura, Noboru; Lädermann, Alexandre; Denard, Patrick J.; Walch, Gilles.
In: Journal of Shoulder and Elbow Surgery, Vol. 23, No. 8, 2014, p. 1195-1202.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion
AU - Collin, Philippe
AU - Matsumura, Noboru
AU - Lädermann, Alexandre
AU - Denard, Patrick J.
AU - Walch, Gilles
PY - 2014
Y1 - 2014
N2 - Background: Management of massive chronic rotator cuff tears remains controversial, with no clearly defined clinical presentation as yet. The purpose of the study was to evaluate the effect of tear size and location on active motion in patients with chronic and massive rotator cuff tears with severe muscle degeneration. Methods: One hundred patients with massive rotator cuff tears accompanied by muscle fatty infiltration beyond Goutallier stage 3 were prospectively included in this study. All patients were divided into 5 groups on the basis of tear pattern (supraspinatus, superior subscapularis, inferior subscapularis, infraspinatus, and teres minor). Active range of shoulder motion was assessed in each group and differences were analyzed. Results: Active elevation was significantly decreased in patients with 3 tear patterns involved. Pseudoparalysis was found in 80% of the cases with supraspinatus and complete subscapularis tears and in 45% of the cases with tears involving the supraspinatus, infraspinatus, and superior subscapularis. Loss of active external rotation was related to tears involving the infraspinatus and teres minor; loss of active internal rotation was related to tears of the subscapularis. Conclusions: This study revealed that dysfunction of the entire subscapularis and supraspinatus or 3 rotator cuff muscles is a risk factor for pseudoparalysis. For function to be preserved in patients with massive chronic rotator cuff tears, it may be important to avoid fatty infiltration with anterior extension into the lower subscapularis or involvement of more than 2 rotator cuff muscles.
AB - Background: Management of massive chronic rotator cuff tears remains controversial, with no clearly defined clinical presentation as yet. The purpose of the study was to evaluate the effect of tear size and location on active motion in patients with chronic and massive rotator cuff tears with severe muscle degeneration. Methods: One hundred patients with massive rotator cuff tears accompanied by muscle fatty infiltration beyond Goutallier stage 3 were prospectively included in this study. All patients were divided into 5 groups on the basis of tear pattern (supraspinatus, superior subscapularis, inferior subscapularis, infraspinatus, and teres minor). Active range of shoulder motion was assessed in each group and differences were analyzed. Results: Active elevation was significantly decreased in patients with 3 tear patterns involved. Pseudoparalysis was found in 80% of the cases with supraspinatus and complete subscapularis tears and in 45% of the cases with tears involving the supraspinatus, infraspinatus, and superior subscapularis. Loss of active external rotation was related to tears involving the infraspinatus and teres minor; loss of active internal rotation was related to tears of the subscapularis. Conclusions: This study revealed that dysfunction of the entire subscapularis and supraspinatus or 3 rotator cuff muscles is a risk factor for pseudoparalysis. For function to be preserved in patients with massive chronic rotator cuff tears, it may be important to avoid fatty infiltration with anterior extension into the lower subscapularis or involvement of more than 2 rotator cuff muscles.
KW - Active range of motion
KW - Classification
KW - Massive rotator cuff tear
KW - Pseudoparalysis
KW - Shoulder
KW - Subscapularis tear
UR - http://www.scopus.com/inward/record.url?scp=84904809893&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904809893&partnerID=8YFLogxK
U2 - 10.1016/j.jse.2013.11.019
DO - 10.1016/j.jse.2013.11.019
M3 - Article
VL - 23
SP - 1195
EP - 1202
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
SN - 1058-2746
IS - 8
ER -