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Muniandy M, Niglis L, Claude Dosch J, Meyer N, Kempf JF, Collin P. Postoperative rotator cuff integrity: can we consider type 3 Sugaya classification as retear? J Shoulder Elbow Surg 2021; 30:97-103. [PMID: 32778379 DOI: 10.1016/j.jse.2020.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sugaya classification is a widely accepted classification system that is used to analyze postoperative rotator cuff tendon integrity. However, there are inconsistencies in the literature as to whether type 3 Sugaya should be considered as a retear or healed tendon. PURPOSE We aimed to show that type 3 Sugaya is not a retear by comparing the long-term supraspinatus and infraspinatus muscle degeneration and the functional outcomes of type 3 with those of type 4 and 5 Sugaya. We hypothesized that the clinical course of type 3 Sugaya would be different from type 4 or 5 Sugaya. METHOD The study was a retrospective multicenter review of all the rotator cuff repair done in 2003-2004. We included all the patients who had undergone supraspinatus repair with 10-year follow-up (magnetic resonance imaging done with full functional assessment). Data collection included pre- and postoperative supraspinatus and infraspinatus fatty infiltration, supraspinatus muscle atrophy, and Constant score with a separate analysis of its Strength subsection. Supraspinatus tendon integrity at 10-year follow-up was determined according to Sugaya classification. The patients were divided into 2 groups: type 3 Sugaya and type 4 and 5 Sugaya. Statistical comparison was done between the groups. RESULTS There was no significant difference in the preoperative fatty infiltration of the supraspinatus and infraspinatus, supraspinatus muscle atrophy, and Constant score between the 2 groups. However, type 3 Sugaya patients had significantly better scores in the preoperative Strength subsection. Postoperatively, type 3 Sugaya patients showed significantly lesser fatty infiltration of the supraspinatus and infraspinatus, lesser supraspinatus muscle atrophy, and higher Constant score compared with type 4 and 5 Sugaya (P < .001). CONCLUSION Patients with type 3 Sugaya supraspinatus tendon exhibited lesser muscle degeneration in the supraspinatus and infraspinatus and performed better in functional assessment compared with type 4 and 5 Sugaya patients. We inferred that type 3 Sugaya should not be considered as a retear.
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Affiliation(s)
| | - Lucas Niglis
- Service de chirurgie orthopédique du membre supérieur, CCOM, Illkirch, France
| | | | - Nicolas Meyer
- Laboratoire de biostatistique, hôpital civil, Strasbourg, France
| | - Jean Francois Kempf
- Service de chirurgie orthopédique du membre supérieur, CCOM, Illkirch, France
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Collin P, Hervé A, Walch G, Boileau P, Muniandy M, Chelli M. Mid-term results of reverse shoulder arthroplasty for glenohumeral osteoarthritis with posterior glenoid deficiency and humeral subluxation. J Shoulder Elbow Surg 2019; 28:2023-2030. [PMID: 31405717 DOI: 10.1016/j.jse.2019.03.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Results of anatomic shoulder arthroplasty for glenohumeral osteoarthritis with severe glenoid retroversion are unpredictable with a high rate of glenoid loosening. Reverse shoulder arthroplasty (RSA) has been suggested as an alternative, with good early results. We sought to confirm this at longer follow-up (minimum 5 years). The study hypothesis was that early results would endure over time. METHODS We retrospectively reviewed all RSAs performed in 7 centers from 1998 to 2010. The inclusion criteria were primary glenohumeral osteoarthritis with B1, B2, B3, or C glenoid. Forty-nine shoulders in 45 patients fulfilled the criteria. Bone grafting was performed in 16 cases. Clinical outcomes were evaluated with the Constant score (CS) and shoulder range of motion. RESULTS The mean total CS increased from 30 preoperatively to 68 points (P < .001) with significant improvements in all the subsections of the CS and range of motion. Scapular notching was observed in 20 shoulders (43%), grade 1 in 5 (11%), grade 2 in 7 (15%), grade 3 in 5 (11%), and grade 4 in 3 (6%). The glenoid bone graft healed in all the shoulders. Partial inferior lysis of the bone graft was present in 8 cases (50%). Scapular notching and glenoid bone graft resorption had no influence on the CS (P = .147 and P = .798). CONCLUSION RSA for the treatment of primary glenohumeral osteoarthritis in patients with posterior glenoid deficiency and humeral subluxation without rotator cuff insufficiency resulted in excellent clinical outcomes at a minimum of 5 years of follow-up.
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Affiliation(s)
- Philippe Collin
- Institut Locomoteur de l'Ouest, CHP St Grégoire, St Grégoire, France.
| | - Anthony Hervé
- Service de Chirurgie Orthopédique et Traumatologique CHU Pontchaillou Rennes, Rennes, France
| | - Gilles Walch
- Service de Chirurgie Orthopédique, Clinique Santy, Lyon, France
| | - Pascal Boileau
- Service de Chirurgie Orthopédique et Traumatologique, CHU Hôpital Pasteur 2, Nice, France
| | | | - Mickael Chelli
- Service de Chirurgie Orthopédique et Traumatologique, CHU Hôpital Pasteur 2, Nice, France
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Muniandy M, Rajagopal S, Tahir SH. Arthroscopic All-Inside Repair of Tear of the Anterior Horn of Discoid Lateral Meniscus. Surg J (N Y) 2019; 5:e35-e37. [PMID: 31093532 PMCID: PMC6517238 DOI: 10.1055/s-0039-1688951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/02/2019] [Indexed: 11/28/2022] Open
Abstract
The anterior horn of lateral meniscus tear is usually repaired using outside-in technique. Although easy to perform, it was associated with several complications which may alter the outcome of the surgery. Here, we present a case of an adolescent girl presented with incomplete discoid lateral meniscus accompanied by tear of anterior horn. The tear was repaired using all-inside technique without any implants. We described the surgical technique and discussed the rationale.
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Pietiläinen KH, Ismail K, Järvinen E, Heinonen S, Tummers M, Bollepalli S, Lyle R, Muniandy M, Moilanen E, Hakkarainen A, Lundbom J, Lundbom N, Rissanen A, Kaprio J, Ollikainen M. DNA methylation and gene expression patterns in adipose tissue differ significantly within young adult monozygotic BMI-discordant twin pairs. Int J Obes (Lond) 2015; 40:654-61. [PMID: 26499446 DOI: 10.1038/ijo.2015.221] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 08/29/2015] [Accepted: 09/21/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Little is known about epigenetic alterations associated with subcutaneous adipose tissue (SAT) in obesity. Our aim was to study genome-wide DNA methylation and gene expression differences in SAT in monozygotic (MZ) twin pairs who are discordant for body mass index (BMI). This design completely matches lean and obese groups for genetic background, age, gender and shared environment. METHODS 14We analyzed DNA methylome and gene expression from SAT, together with body composition (magnetic resonance imaging/spectroscopy) and glucose tolerance test, lipids and C-reactive protein from 26 rare BMI-discordant (intrapair difference in BMI ⩾3 kg m(-2)) MZ twin pairs identified from 10 birth cohorts of young adult Finnish twins. RESULTS We found 17 novel obesity-associated genes that were differentially methylated across the genome between heavy and lean co-twins. Nine of them were also differentially expressed. Pathway analyses indicated that dysregulation of SAT in obesity includes a paradoxical downregulation of lipo/adipogenesis and upregulation of inflammation and extracellular matrix remodeling. Furthermore, CpG sites whose methylation correlated with metabolically harmful fat depots (intra-abdominal and liver fat) also correlated with measures of insulin resistance, dyslipidemia and low-grade inflammation, thus suggesting that epigenetic alterations in SAT are associated with the development of unhealthy obesity. CONCLUSION This is the first study in BMI-discordant MZ twin pairs reporting genome-wide DNA methylation and expression profiles in SAT. We found a number of novel genes and pathways whose methylation and expression patterns differ within the twin pairs, suggesting that the pathological adaptation of SAT to obesity is, at least in part, epigenetically regulated.
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Affiliation(s)
- K H Pietiläinen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Central Hospital, and University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - K Ismail
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Järvinen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - S Heinonen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - M Tummers
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - S Bollepalli
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R Lyle
- Oslo University Hospital and University of Oslo, Department of Medical Genetics, Oslo, Norway
| | - M Muniandy
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Moilanen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - A Hakkarainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany
| | - N Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Rissanen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - J Kaprio
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - M Ollikainen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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