Journal List > Korean J Sports Med > v.33(2) > 1054551

TOOLS
Korean J Sports Med. 2015 Dec;33(2):67-74. Korean.
Published online December 07, 2015.  https://doi.org/10.5763/kjsm.2015.33.2.67
Copyright © 2015 The Korean Society of Sports Medicine
Factors Influencing the Restoration of Acromiohumeral Distance of Immediate Postoperative Period in Patients Who Have Rotator Cuff Repair Surgery with Large-to-Massive Rotator Cuff Tears
Byung Wook Song, Woo Kim and Tae-Yon Rhie
Department of Orthopaedic Surgery, Nalgae Hospital, Seoul, Korea.

Correspondence: Byung Wook Song. Department of Orthopaedic Surgery, Nalgae Hospital, 193-1 Moohak-ro, Dongdaemoon-gu, Seoul 02578, Korea. Tel: +82-2-959-9191, Fax: +82-2-957-1313, Email: wookari@empas.com
Received July 09, 2015; Revised November 06, 2015; Accepted November 10, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

The aim of the present study was to evaluate the degree of restoration of acromiohumeral distance of immediate postoperative period in patients who have rotator cuff repair surgery with large-to-massive rotator cuff tears and to find clinical and radiologic factors influencing this. Fifty four patients who had arthroscopic rotator cuff repair with available postoperative magnetic resonance images done within postoperative one week were included. Retrospective review of the medical data and radiologic images was done. It was revealed that acromiohumeral distance of immediate postoperative period was smaller in patients with larger sized rotator cuff tears, more retraction of the torn end and narrower preoperative acromiohumeral distance. The degree of inferior migration of the humeral head which could be obtained through the surgery alone was more in patients who have more difference between acromiohumeral distance measured on preoperative standing simple radiography and acromiohumeral distance measured on preoperative magnetic resonance image.

Keywords: Shoulder; Rotator cuff; Acromion; Humerus

Figures


 Fig. 1
Measurement of acromiohumeral distance on simple radiography. The first proximal line is placed upon the sclerotic line, representing the "roof" at the undersurface of the acromion. The second line is drawn parallel to the first tangentially to the most superior point of the humeral head.
Click for larger image


Fig. 2
Measurement of acromiohumeral distance on T2-weighted fat suppression magnetic resonance imaging. The first line is placed at the most distal part of the acromion appearing to the bone, and the second line is drawn through the superior most point of bony part of the humerus (not onto cartilage). The respective distance between the 2 lines represents the acromiohumeral distance. Preop: peroperative, Postop: postoperative.
Click for larger image


Fig. 3
Illustration of the calculation of the IMH. PreMR_AHD: acromiohumeral distance on preoperative magnetic resonance imaging, IMH: inferior migration of the humerus, BR: the thickness of the resected bone by acromioplasty, IMH: inferior migration of the humerus, MRI: magnetic resonance imaging.
Click for larger image

Tables


 Table 1
Clinical variables considered
Click for larger image


Table 2
Results of measurement of the radiologic variables
Click for larger image


Table 3
Correlation of postoperative acromiohumeral distance and inferior migration of humeral head with clinical and radiologic variables
Click for larger image

Notes

Conflict of Interest:No potential conflict of interest relevant to this article was reported.

References
1. Saupe N, Pfirrmann CW, Schmid MR, Jost B, Werner CM, Zanetti M. Association between rotator cuff abnormalities and reduced acromiohumeral distance. AJR Am J Roentgenol 2006;187:376–382.
2. Hartzler RU, Sperling JW, Schleck CD, Cofield RH. Clinical and radiographic factors influencing the results of revision rotator cuff repair. Int J Shoulder Surg 2013;7:41–45.
3. Comtet JJ, Auffray Y. Physiology of the elevator muscles of the shoulder. Rev Chir Orthop Reparatrice Appar Mot 1970;56:105–117.
4. Goupille P, Anger C, Cotty P, Fouquet B, Soutif D, Valat JP. Value of standard radiographies in the diagnosis of rotator cuff rupture. Rev Rhum Ed Fr 1993;60:440–444.
5. Goutallier D, Le Guilloux P, Postel JM, Radier C, Bernageau J, Zilber S. Acromio humeral distance less than six millimeter: its meaning in full-thickness rotator cuff tear. Orthop Traumatol Surg Res 2011;97:246–251.
6. Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg Am 1983;65:456–460.
7. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears: a long-term observation. Clin Orthop Relat Res 1990;(254):92–96.
8. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994;(304):78–83.
9. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999;8:599–605.
10. Werner CM, Conrad SJ, Meyer DC, Keller A, Hodler J, Gerber C. Intermethod agreement and interobserver correlation of radiologic acromiohumeral distance measurements. J Shoulder Elbow Surg 2008;17:237–240.
11. Gruber G, Bernhardt GA, Clar H, Zacherl M, Glehr M, Wurnig C. Measurement of the acromiohumeral interval on standardized anteroposterior radiographs: a prospective study of observer variability. J Shoulder Elbow Surg 2010;19:10–13.
12. Lehtinen JT, Belt EA, Lyback CO, et al. Subacromial space in the rheumatoid shoulder: a radiographic 15-year follow-up study of 148 shoulders. J Shoulder Elbow Surg 2000;9:183–187.
13. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 1986;68:1136–1144.
14. Walch G, Marechal E, Maupas J, Liotard JP. Surgical treatment of rotator cuff rupture: prognostic factors. Rev Chir Orthop Reparatrice Appar Mot 1992;78:379–388.
15. Chung SW, Kim JY, Kim MH, Kim SH, Oh JH. Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors associated with healing failure or poor postoperative function. Am J Sports Med 2013;41:1674–1683.
16. Kim SJ, Lee IS, Kim SH, Lee WY, Chun YM. Arthroscopic partial repair of irreparable large to massive rotator cuff tears. Arthroscopy 2012;28:761–768.
17. Park JY, Lhee SH, Oh KS, Moon SG, Hwang JT. Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear. Arthroscopy 2013;29:280–289.
18. Jost B, Pfirrmann CW, Gerber C, Switzerland Z. Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 2000;82:304–314.
19. Weiner DS, Macnab I. Superior migration of the humeral head. A radiological aid in the diagnosis of tears of the rotator cuff. J Bone Joint Surg Br 1970;52:524–527.
20. Nove-Josserand L, Edwards TB, O'Connor DP, Walch G. The acromiohumeral and coracohumeral intervals are abnormal in rotator cuff tears with muscular fatty degeneration. Clin Orthop Relat Res 2005;(433):90–96.
21. Wellmann M, Lichtenberg S, da Silva G, Magosch P, Habermeyer P. Results of arthroscopic partial repair of large retracted rotator cuff tears. Arthroscopy 2013;29:1275–1282.
TOOLS
Similar articles

Revisional Rotator Cuff Repair

Treatment of Massive Rotator Cuff Tears: Focusing on Arthroscopic Approach

Current Concepts of Arthroplasty for the Treatment of Massive Rotator Cuff Tears

Management of Massive Rotator Cuff Tears: Role of the Tendon Augmentation

Massive Tear of the Rotator Cuff