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Skeletal Radiology

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07.07.2018 | Scientific Article

Patterns of tendon retraction in full-thickness rotator cuff tear: comparison of delaminated and nondelaminated tendons

verfasst von: Guillaume Bierry, William E. Palmer

Erschienen in: Skeletal Radiology | Ausgabe 1/2019

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Abstract

Objective

To analyze full-thickness rotator cuff tears, compare retraction patterns in delaminated and nondelaminated tendons, and correlate retraction distances with anteroposterior tear lengths.

Materials and methods

In 483 MR examinations reported as showing full-thickness cuff tear, two musculoskeletal radiologists independently characterized tendons as delaminated or nondelaminated. Tendon delamination was defined as either horizontal intra-substance splitting of bursal and articular layers by an intervening plane of fluid, or differential retraction of bursal and articular layers. In a subset of 144 shoulders with surgically proven full-thickness cuff tears (45 delaminated, 99 nondelaminated tendons), matched cohorts (n = 45) were further analyzed to compare tendon retraction distance, anteroposterior tear length and retraction ratios (retraction distance/anteroposterior length).

Results

Delamination was present in 13% of 483 total tears, and 31% of 144 operated tears (p = 0.001). In nondelamination and delamination cohorts, mean anteroposterior tear length measured 30.0 and 31.5 mm respectively (p = 0.6). Although nondelaminated tendons showed mean retraction 31.5 mm, articular and bursal layers of delaminated tendons showed mean retractions 36.3 mm and 21 mm respectively (p < 0.0001). Anteroposterior tear length and retraction distance were significantly associated in all cuff tears (p < 0.0001). Retraction ratio for nondelaminated tendons (1.05) was significantly different from retraction ratios for articular (1.21) and bursal (0.70) layers of delaminated tendons (p < 0.0001).

Conclusion

In full-thickness rotator cuff tear, delaminated and nondelaminated tendons show significant differences in retraction distances, despite similarities in anteroposterior dimensions. Delaminated tendons are important to identify and report because they are more likely to fail conservative treatments and undergo operative repairs.

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Titel: Patterns of tendon retraction in full-thickness rotator cuff tear: comparison of delaminated and nondelaminated tendons
verfasst von: Guillaume Bierry
William E. Palmer
Publikationsdatum: 07.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Skeletal Radiology / Ausgabe 1/2019
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-018-3013-6

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