ArticleOrthopaedic journal of sports medicine2019
Effect of Muscle Quality on Operative and Nonoperative Treatment of Rotator Cuff Tears.
Article in Orthopaedic journal of sports medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Artificial Intelligence Predicts Failure of Nonoperative Treatment in Degenerative Posterosuperior Rotator Cuff Tears.Arthroscopy, sports medicine, and rehabilitation · 2026Article
- Association between hormone replacement therapy and clinical outcomes in women with rotator cuff tears.Archives of ISPRM · 2026Article
- Oxandrolone treatment prevents muscle atrophy and retraction after rotator cuff injury: an experimental study in rats.JSES reviews, reports, and techniques · 2025Article
- Muscle Health & Fatty Infiltration with Advanced Rotator Cuff Pathology.Current reviews in musculoskeletal medicine · 2025Review
- A visual marker for early atrophy of the supraspinatus muscle on conventional MRI: introduction of the blackbird sign.European radiology · 2025Article
- Muscle belly ratio is the most suitable estimate of the activity of the torn supraspinatus muscle.JSES international · 2023Article
- Emerging Role of Quantitative Ultrasound-Based Imaging Techniques for Characterizing Rotator Cuff Tears: A Scoping Review.Diagnostics (Basel, Switzerland) · 2023Article
- Three-Grade Magnetic Resonance Imaging-Based Gluteus Medius and/or Minimus Tear Classification System Provides Excellent Inter-Rater Reliability.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- High-accuracy detection of supraspinatus fatty infiltration in shoulder MRI using convolutional neural network algorithms.Frontiers in medicine · 2023Article
- Prognostic factors for improvement of shoulder function after arthroscopic rotator cuff repair: a systematic review.JSES international · 2023Review
- Agreement in rotator cuff muscles measurement between ultrasonography and magnetic resonance imaging.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2022Article
- Predictors of clinical outcomes after non-operative management of symptomatic full-thickness rotator cuff tears.World journal of orthopedics · 2021Article
- Magnetic resonance imaging of the shoulder.Polish journal of radiology · 2020Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRotator cuff muscle atrophy and fatty infiltration are predictors of negative outcomes after rotator cuff repair. However, the impact of muscle degeneration on nonsurgical treatment is unknown. HYPOTHESIS: Rotator cuff muscle atrophy and fatty infiltration will reduce the outcomes of operative repair while having a minimal effect on nonsurgical treatment. Additionally, in the setting of atrophy and fatty infiltration, surgical and nonsurgical treatment will produce equivalent outcomes. STUDY
designCohort study; Level of evidence, 2.
methodsPatients undergoing operative and nonoperative treatment of full-thickness rotator cuff tears were prospectively enrolled into a nonrandomized cohort study. Muscle quality was assessed on magnetic resonance imaging by use of the supraspinatus tangent sign, Warner atrophy, and Goutallier fatty infiltration classifications. Grading was performed by 2 independent observers who were blinded to patient treatment and outcomes. Normalized Western Ontario Rotator Cuff (WORC) index was the primary patient-reported outcome. Multivariate linear regression analysis was used to determine the impact of muscle quality on treatment outcomes.
resultsThe cohort consisted of 157 patients, 89 (57%) surgical and 68 (43%) nonsurgical, with a mean follow-up of 2.4 years (range, 1-5 years). Tangent sign had the best inter- and intrarater reliability, with kappa statistics of 0.81 and 0.86, respectively. Reliability for Warner atrophy was 0.69 to 0.76 and for Goutallier classification was 0.54 to 0.64. Overall, improvement in WORC scores was higher in the surgical group than the nonsurgical group (39.3 vs 21.2;
conclusionA positive tangent sign was predictive of worse operative outcomes, resulting in equivalent improvements between surgical and nonsurgical treatment. The tangent sign is a reliable, prognostic indicator that clinicians can use when counseling patients on the optimal treatment of rotator cuff tears.
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