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Yoon JY, Han H, Shin MY, Jeong HJ, Kang Y, Jeon YD, Kim JU, Oh JH. What is the most predictive magnetic resonance imaging finding of rotator cuff tear concomitant with shoulder stiffness? JSES Int 2023; 7:756-762. [PMID: 37719831 PMCID: PMC10499857 DOI: 10.1016/j.jseint.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background Common magnetic resonance imaging (MRI) findings in adhesive capsulitis are not often evident in rotator cuff tear concomitant with shoulder stiffness. This study aimed to determine the most predictive MRI finding of rotator cuff tear with shoulder stiffness to differentiate from that without stiffness. Materials and methods The data of patients who underwent arthroscopic rotator cuff repair between January 2014 and October 2019 were retrospectively reviewed. Stiffness was defined as forward flexion <120°, external rotation at side <30°, and internal rotation at back Results Anterior capsular thickness, glenoid capsular thickness in the axillary recess, and anterior and axillary capsular hyperintensities were significantly more dominant in the stiff group (all P < .05) than in the control group. Anterior capsular thickness and anterior capsular abnormal hyperintensity could be used to differentiate between the stiff and control groups (P < .05). Anterior capsular thickness showed high diagnostic performance with an area under the receiver operating characteristic curve of 0.993. The cut-off value for stiffness was 3.07 mm (sensitivity, 96.1%; specificity, 100%). Conclusion Anterior capsular thickening and abnormal hyperintensity were the most predictive MRI findings for stiffness in patients with rotator cuff tear and stiffness to differentiate from patients with rotator cuff tear without stiffness.
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Affiliation(s)
- Ji Young Yoon
- Department of Orthopaedic Surgery, National Police Hospital, Seoul, Republic of Korea
| | - HeeSoo Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Myoung Yeol Shin
- Department of Orthopaedic Surgery, National Police Hospital, Seoul, Republic of Korea
| | - Hyeon Jang Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yusuhn Kang
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Young Dae Jeon
- Department of Orthopaedic Surgery, Ulsan University College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Ji Un Kim
- Department of Orthopaedic Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Joo Han Oh
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Shinohara I, Mifune Y, Inui A, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T, Kuroda R. Advanced glycation end products are associated with limited range of motion of the shoulder joint in patients with rotator cuff tears associated with diabetes mellitus. BMC Musculoskelet Disord 2022; 23:271. [PMID: 35317765 PMCID: PMC8939191 DOI: 10.1186/s12891-022-05229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Most degenerative rotator cuff tears (RCTs) are associated with a limited range of motion (ROM) of the shoulder joint. Additionally, patients with diabetes mellitus (DM) show a higher frequency of limited ROM. Recently, advanced glycation end products (AGEs) of proteins have been observed to cause tissue fibrosis, primarily through abnormal collagen cross-linking and oxidative stress. In this study, we investigated the effect of AGEs on ROM limitation in the shoulder capsule and its relationship with DM in the patients with RCTs. Methods Sixteen patients (eight in the DM and non-DM groups) who underwent arthroscopic surgery for RCT with limited shoulder ROM were included in this study. AGE-related pathologies in both groups were compared, and the relationship between AGE accumulation and shoulder joint ROM was evaluated. Shoulder capsule tissue was harvested and subjected to histological and in vitro evaluation. Results The DM group displayed high levels of AGEs and reactive oxygen species (ROS), and reduced cell viability. There was a significant positive correlation between ROS expression, apoptosis, and preoperative hemoglobin A1c. ROS expression, apoptosis, and ROM of the shoulder joint showed a negative correlation. The NADPH oxidase (NOX) expression and collagen III/I ratio were significantly higher in the DM group than in the non-DM group. Conclusions The DM group showed significant AGEs deposition in the shoulder capsule. Additionally, there was a significant association between AGEs and ROM limitation. Collectively, the findings suggest that the oxidative stress induced by AGEs deposition, which leads to fibrosis and local inflammation, might contribute to the limited ROM of the shoulder joint in patients with RCTs accompanied by DM.
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Affiliation(s)
- Issei Shinohara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan.
| | - Atsuyuki Inui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Hanako Nishimoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Kohei Yamaura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Shintaro Mukohara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Tomoya Yoshikawa
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Tatsuo Kato
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Takahiro Furukawa
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 5-2, Kusunoki-cho7, Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan
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Comparative Analysis of Real-Time Dynamic Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Rotator Cuff Tear Injury. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2107693. [PMID: 34887929 PMCID: PMC8651368 DOI: 10.1155/2021/2107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
Objective To explore the value of real-time dynamic ultrasound and magnetic resonance imaging (MRI) in the diagnosis of rotator cuff injury. Methods From January 2020 to June 2021, the clinical data of 55 patients with rotator cuff injury were collected. All patients were examined by real-time dynamic ultrasound and MRI at the same time within two weeks before surgery, which was confirmed by arthroscopy. The value of real-time dynamic ultrasound, MRI, and the real-time dynamic ultrasound combined with MRI in the diagnosis of rotator cuff injury was evaluated. Results Among the 55 patients with rotator cuff injury, real-time dynamic ultrasound showed full-thickness rotator cuff tear in 12 patients (21.82%), including type I in 2 patients (3.64%), type II in 6 patients (10.91%), and type III in 4 patients (7.27%), and partial rotator cuff tear in 31 patients (56.36%), including type IV in 16 patients (29.00%), type V in 5 patients (9.09%), and type VI in 10 patients (18.18%). MRI showed full-thickness rotator cuff tear in 12 patients (21.82%), including type I in 2 patients (3.64%), type II in 6 patients (10.91%), and type III in 4 patients (7.27%), and partial rotator cuff tear in 37 patients (67.27%), including type IV in 20 patients (36.36%), type V in 7 patients (12.73%), and type VI in 10 patients (18.18%). The combined examination showed full-thickness rotator cuff tear in 12 patients (21.82%), including type I in 2 patients (3.64%), type II in 6 patients (10.91%), and type III in 4 patients (7.27%), and partial rotator cuff tear in 39 cases (70.91%), including type IV in 21 cases (38.12%), type V in 7 patients (12.73%), and type VI in 12 patients (21.82%). The diagnostic accuracy of real-time dynamic ultrasound in complete tearing, partial tearing and the overall accuracy were 92.31%, 73.81% and 78.18%, respectively. The diagnostic accuracy of complete tear, partial tear and the overall accuracy of MRI were 92.31%, 88.00% and 89.09%, respectively. The diagnostic accuracy of complete tear and partial tear and overall accuracy in the real-time dynamic ultrasound combined with MRI were 92.31%, 95.24%, and 94.55%, respectively. The diagnostic accuracy and overall diagnostic accuracy of the combined examination of partial tears were higher than those of the real-time dynamic ultrasound and MRI examinations alone. Conclusion Real-time dynamic ultrasound and MRI have high application value in the diagnosis of rotator cuff injury, and the combined diagnosis is conducive to improving the diagnostic accuracy of patients with partial tear.
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Katthagen JC, Schliemann B, Dyrna F, Raschke MCEJ. [Posttraumatic shoulder stiffness]. Unfallchirurg 2021; 124:241-251. [PMID: 33590264 DOI: 10.1007/s00113-021-00956-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
Posttraumatic stiffness of the shoulder joint is a frequent and socioeconomically relevant result of injury; however, prior to making the diagnosis as the only cause of a persisting impairment of motion, it is necessary to rule out other sequelae of trauma. Even intensive conservative treatment is mostly accompanied by the stagnation of the impairments of movement. In many cases the treatment of choice is early arthroscopic arthrolysis with a standardized approach and intensive follow-up treatment. In the surgical treatment of proximal humeral fractures with humeral head preservation, arthroscopic arthrolysis with simultaneous implant removal is a form of planned second intervention for improvement of shoulder function in cases of persisting motion deficits after bony consolidation. Despite sometimes substantial limitations of movement, a clinically relevant and lasting improvement of shoulder function can be achieved with arthroscopic arthrolysis in posttraumatic shoulder stiffness.
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Affiliation(s)
- J Christoph Katthagen
- Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1 48149, Münster, Deutschland.
| | - Benedikt Schliemann
- Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1 48149, Münster, Deutschland
| | - Felix Dyrna
- Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1 48149, Münster, Deutschland
| | - Mi Cha El J Raschke
- Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1 48149, Münster, Deutschland
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