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Multivariate analyses of rotator cuff pathologies in shoulder disability.

Henseler JF, Raz Y, Nagels J, van Zwet EW, Raz V, Nelissen RG - PLoS ONE (2015)

Bottom Line: The individual or combinatorial contribution of RC measures to superior humeral translation, as a sign of RC dysfunction, was investigated with univariate or multivariate models, respectively.With the multivariate model, however, the infraspinatus surface area only affected superior humeral translation (p<0.001) and discriminated between superior and posterosuperior tears.In contrast neither tear size nor fatty infiltration of the supraspinatus or infraspinatus contributed to superior humeral translation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO box 9600, 2300 RC Leiden, the Netherlands.

ABSTRACT

Background: Disability of the shoulder joint is often caused by a tear in the rotator cuff (RC) muscles. Four RC muscles coordinate shoulder movement and stability, among them the supraspinatus and infraspinatus muscle which are predominantly torn. The contribution of each RC muscle to tear pathology is not fully understood. We hypothesized that muscle atrophy and fatty infiltration, features of RC muscle degeneration, are predictive of superior humeral head translation and shoulder functional disability.

Methods: Shoulder features, including RC muscle surface area and fatty infiltration, superior humeral translation and RC tear size were obtained from a consecutive series of Magnetic Resonance Imaging with arthrography (MRA). We investigated patients with superior (supraspinatus, n = 39) and posterosuperior (supraspinatus and infraspinatus, n = 30) RC tears, and patients with an intact RC (n = 52) as controls. The individual or combinatorial contribution of RC measures to superior humeral translation, as a sign of RC dysfunction, was investigated with univariate or multivariate models, respectively.

Results: Using the univariate model the infraspinatus surface area and fatty infiltration in both the supraspinatus and infraspinatus had a significant contribution to RC dysfunction. With the multivariate model, however, the infraspinatus surface area only affected superior humeral translation (p<0.001) and discriminated between superior and posterosuperior tears. In contrast neither tear size nor fatty infiltration of the supraspinatus or infraspinatus contributed to superior humeral translation.

Conclusion: Our study reveals that infraspinatus atrophy has the strongest contribution to RC tear pathologies. This suggests a pivotal role for the infraspinatus in preventing shoulder disability.

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Related in: MedlinePlus

Means and standard errors of the means of the acromiohumeral distance and the cross sectional surface area of the supraspinatus and infraspinatus between the patient groups.Compared to controls: * p < 0.05; ** p < 0.001
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pone.0118158.g003: Means and standard errors of the means of the acromiohumeral distance and the cross sectional surface area of the supraspinatus and infraspinatus between the patient groups.Compared to controls: * p < 0.05; ** p < 0.001

Mentions: Patient characteristics were stratified for diagnosis and are summarized in Table 1. Compared to controls, patients with a RC tear had a decreased AH distance (p = 0.02), and reduced surface area of the SSp and ISp muscles (p<0.001 and p = 0.002, respectively) (Fig. 3A). Patients with a RC tear were significantly older compared to controls (p<0.001). Patients with a RC tear had more fatty infiltration in SSp and ISp muscles (p<0.001 for both), compared to controls. Lastly, within the control group, the radius of the humeral head was strongly correlated with the surface of the SSp and ISp (Pearson correlation 0.566 and 0.350; p<0.001 and p = 0.04, respectively), whereas within the RC tear group only weak correlation was found between the radius of the humeral head and the surface of the SSp and ISp (Pearson correlation 0.203 and 0.120; p = 0.09 and p = 0.33, respectively) (Table 1).


Multivariate analyses of rotator cuff pathologies in shoulder disability.

Henseler JF, Raz Y, Nagels J, van Zwet EW, Raz V, Nelissen RG - PLoS ONE (2015)

Means and standard errors of the means of the acromiohumeral distance and the cross sectional surface area of the supraspinatus and infraspinatus between the patient groups.Compared to controls: * p < 0.05; ** p < 0.001
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4339721&req=5

pone.0118158.g003: Means and standard errors of the means of the acromiohumeral distance and the cross sectional surface area of the supraspinatus and infraspinatus between the patient groups.Compared to controls: * p < 0.05; ** p < 0.001
Mentions: Patient characteristics were stratified for diagnosis and are summarized in Table 1. Compared to controls, patients with a RC tear had a decreased AH distance (p = 0.02), and reduced surface area of the SSp and ISp muscles (p<0.001 and p = 0.002, respectively) (Fig. 3A). Patients with a RC tear were significantly older compared to controls (p<0.001). Patients with a RC tear had more fatty infiltration in SSp and ISp muscles (p<0.001 for both), compared to controls. Lastly, within the control group, the radius of the humeral head was strongly correlated with the surface of the SSp and ISp (Pearson correlation 0.566 and 0.350; p<0.001 and p = 0.04, respectively), whereas within the RC tear group only weak correlation was found between the radius of the humeral head and the surface of the SSp and ISp (Pearson correlation 0.203 and 0.120; p = 0.09 and p = 0.33, respectively) (Table 1).

Bottom Line: The individual or combinatorial contribution of RC measures to superior humeral translation, as a sign of RC dysfunction, was investigated with univariate or multivariate models, respectively.With the multivariate model, however, the infraspinatus surface area only affected superior humeral translation (p<0.001) and discriminated between superior and posterosuperior tears.In contrast neither tear size nor fatty infiltration of the supraspinatus or infraspinatus contributed to superior humeral translation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO box 9600, 2300 RC Leiden, the Netherlands.

ABSTRACT

Background: Disability of the shoulder joint is often caused by a tear in the rotator cuff (RC) muscles. Four RC muscles coordinate shoulder movement and stability, among them the supraspinatus and infraspinatus muscle which are predominantly torn. The contribution of each RC muscle to tear pathology is not fully understood. We hypothesized that muscle atrophy and fatty infiltration, features of RC muscle degeneration, are predictive of superior humeral head translation and shoulder functional disability.

Methods: Shoulder features, including RC muscle surface area and fatty infiltration, superior humeral translation and RC tear size were obtained from a consecutive series of Magnetic Resonance Imaging with arthrography (MRA). We investigated patients with superior (supraspinatus, n = 39) and posterosuperior (supraspinatus and infraspinatus, n = 30) RC tears, and patients with an intact RC (n = 52) as controls. The individual or combinatorial contribution of RC measures to superior humeral translation, as a sign of RC dysfunction, was investigated with univariate or multivariate models, respectively.

Results: Using the univariate model the infraspinatus surface area and fatty infiltration in both the supraspinatus and infraspinatus had a significant contribution to RC dysfunction. With the multivariate model, however, the infraspinatus surface area only affected superior humeral translation (p<0.001) and discriminated between superior and posterosuperior tears. In contrast neither tear size nor fatty infiltration of the supraspinatus or infraspinatus contributed to superior humeral translation.

Conclusion: Our study reveals that infraspinatus atrophy has the strongest contribution to RC tear pathologies. This suggests a pivotal role for the infraspinatus in preventing shoulder disability.

Show MeSH
Related in: MedlinePlus