Clin Should Elbow.  2020 Sep;23(3):144-151. 10.5397/cise.2020.00227.

Magnetic resonance imaging analysis of rotator cuff tear after shoulder dislocation in a patient older than 40 years

Affiliations
  • 1Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
  • 2Department of Orthopedic Surgery, Gimhae-Sarang Hospital, Gimhae, Korea
  • 3Department of Orthopedic Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea

Abstract

Background
This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40.
Methods
From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation.
Results
Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event.
Conclusions
This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

Keyword

Dislocation; Magnetic resonance imaging; Rotator cuff; Fatty degeneration; Prognosis
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