Posterior decentering of the humeral head in patients with arthroscopic rotator cuff repair

• Published in: Clinics in Shoulder and Elbow 2022, 25(1), , pp.22-27
• Main Authors: Nakamura, Hidehiro, Gotoh, Masafumi, Honda, Hirokazu, Mitsui, Yasuhiro, Ohzono, Hiroki, Shiba, Naoto, Kume, Shinichiro, Okawa, Takahiro
• Format: Article
• Language: English
• Subjects: humeral head; Original; rotator cuff tear; shoulder; 정형외과학
• ISSN: 2383-8337; 2288-8721
• DOI: 10.5397/cise.2021.00507

Background In some patients with rotator cuff tear (RCT), the axial view of magnetic resonance imaging (MRI) shows subtle posterior decentering (PD) of the humeral head from the glenoid fossa. This is considered to result from a loss of centralization that is typically produced by rotator cuff function. There are few reports on PD in RCT despite the common occurrence of posterior subluxation in degenerative joint disease. In this study, we investigated the effect of PD in arthroscopic rotator cuff repair (ARCR). Methods We conducted a retrospective study of consecutive patients who underwent ARCR at our institute and were followed-up for at least 1 year. PD was identified as a 2-mm posterior shift of the humeral head relative to the glenoid fossa in the axial MRI view preoperatively. The tear size and fatty degeneration (FD, Goutallier classification) were also evaluated using preoperative MRI. Retears were evaluated through MRI at 1 year postoperatively. Results We included 135 shoulders in this study. Ten instances of PD (including seven retears) were observed preoperatively. Fifteen retears (three and 12 retears in the small/medium and large/massive tear groups, respectively) were observed postoperatively. PD was significantly correlated with tear size, FD, and retear occurrence (p