The influence of fatty infiltration and muscle atrophy of the rotator cuff muscles on midterm functional outcomes in total shoulder resurfacing at six years' follow-up.

Abstract

BACKGROUND:

We report functional outcomes at six years in patients with varying degrees of fatty infiltration and atrophy of the rotator cuff muscles who have undergone anatomic total shoulder replacement.

METHODS:

A retrospective analysis of case notes and magnetic resonance imaging scans of patients undergoing total shoulder replacement for primary glenohumeral arthritis was performed. Patients were grouped based upon their pre-operative magnetic resonance imaging findings for fatty infiltration, muscle area and tendinopathy. Post-operative functional outcomes were assessed using the Oxford Shoulder Score and Quick Disabilities of the Arm, Shoulder and Hand score. Post-operative measurements were made for active shoulder movements.

RESULTS:

Thirty-two patients were reviewed at a mean of 67 months following surgery. All patients demonstrated fatty infiltration on their pre-operative magnetic resonance imaging scan. Muscle atrophy was shown in 22 patients and 12 had tendinopathy. Multiple regression analysis showed no correlation between the Oxford Shoulder Score (p = 0.443), the Quick Disabilities of the Arm, Shoulder and Hand score (p = 0.419), forward flexion (p = 0.170), external rotation (p = 0.755) and any of the pre-operative independent variables.

DISCUSSION:

The degree of fatty infiltration, muscle atrophy and tendinopathy of the rotator cuff muscle on pre-operative magnetic resonance imaging scanning is not associated with functional outcome score or functional movement at medium-term follow-up following total shoulder replacement.

LEVEL OF EVIDENCE:

IV.

• Authors: Gray Ad Edwards, Philip A McCann, Michael R Whitehouse, Charles J Wakeley, Partha P Sarangi
• Journal: Shoulder & elbow (Shoulder Elbow) Vol. 12 Issue 2 Pg. 91-98 (Apr 2020) ISSN: 1758-5732 [Print] United States
• PMID: 32313558 (Publication Type: Journal Article)
• Copyright: © 2018 The British Elbow & Shoulder Society.