title: Muscle atrophy and fatty infiltration in rotator cuff tears: Can surgery stop muscular degenerative changes?
abstract: BACKGROUND
  Rotator cuff tears are closely related with muscle atrophy and fatty infiltration and both affect healing after surgical treatment. The aim of this study was to compare surgical versus conservative management of medium-to-large reparable rotator cuff tears.
  
  
  METHODS
  Forty-one patients with clinical and radiological (MRI) diagnosis of medium-to-large rotator cuff tears were retrospectively identified and divided into two groups: Group A, arthroscopic repair; Group B, conservative treatment. At follow-up (T1) all patients underwent a new clinical (VAS, SST, Constant and Relative Constant Scale) and radiological evaluation (MRI).
  
  
  RESULTS
  When comparing the two groups at T1 (mean follow-up: Group A, 50 months; Group B, 61 months), we registered better results in Group A in the SST (p < 0.05), the VAS score (p < 0.01), the Constant and the Relative Constant Scale (p < 0.05). Radiological evaluation did not show a significant increase of fatty infiltration (p = 0.16) in Group A (no progression in 15 out of 17 patients -82.3%-, and an increase in 2 out of 17 patients -11.7%-), while in Group B a significant increase was detected (p < 0.01) in all patients; in regard to muscle atrophy, no cases of progression were detected in Group A (4 out of 17 patients -23.5%- showed an increased post-operative supraspinatus trophysm), while a significant worsening (p < 0.05) was found in Group B. In Group B a significant worsening of tendon retraction (p < 0.01) and of tear size (p = 0.01) was also detected.
  
  
  CONCLUSIONS
  Surgical treatment of complete rotator cuff tears seems to decrease the irreversible changes that involve muscle belly.
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fabbri
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ciompi
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: R M
authors.initials: RM
authors.lastname: Lanzetti
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vadalà
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy. Electronic address: domenico.lupariello@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Lupariello
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Iorio
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Serlorenzi
authors.affiliation: Radiological Department, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Argento
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ferretti
authors.affiliation: Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Carli
mesh_terms: D000273:Adipose Tissue / Q000473:pathology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000473:pathology* / Q000517:prevention & control; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000473:pathology* / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome