DSC examination of rotator cuff damage in patients with total shoulder arthroplasty
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DSC examination of rotator cuff damage in patients with total shoulder arthroplasty László G. Nöt1,2 · András Bata1 · Hajnalka Szabó3 · János Cifra4 · Dénes Lőrinczy5 Received: 10 June 2020 / Accepted: 11 November 2020 © The Author(s) 2020
Abstract The assessment of rotator cuff tear prior to shoulder replacement is based on the physical findings and imaging procedures, preferably magnetic resonance imaging (MRI). However, MRI is not always available, and in trauma patients, the CT-scanbased classification of glenohumeral arthritis or tendon damage is generally not applicable. In case of 4-part dislocated proximal humerus fractures the right diagnosis is crucial prior to choose between different type protheses or osteosyntheses. Therefore, there is a need for novel methods for the evaluation of rotator cuff damage. Our aim was to evaluate whether differential scanning calorimetry (DSC) could determine the grade of rotator cuff damage in patients undergoing shoulder replacement. Small samples of rotator cuff tendons of patients undergoing reversed shoulder replacement due to orthopedic or trauma indications were resected during surgery, and thermal parameters were measured using DSC. Radiological evaluation was also performed to classify the degree of rotator cuff damage and glenohumeral arthritis. In case of orthopedic samples, the consequence of advanced tendon damage was well demonstrated by the shape and the running of the curves, compared to the control sample. In trauma samples, the moderately degenerated tendons also exhibited significant difference from the control in the shape of the scans and in the thermal parameters. DSC curves demonstrated a clear difference in the thermal parameters of healthy and pathologic samples. DSC could be a useful additional method in the evaluation of rotator cuff tear arthropathies in future studies. Keywords DSC · Tendon · Rotator cuff tear · Arthropathy · Trauma · Reversed shoulder replacement
Introduction
* Dénes Lőrinczy [email protected] 1
Department of Traumatology and orthopedics, Balassa János Teaching Hospital of Tolna County, 5‑7 Béri Balogh Ádám Street, Szekszárd 7100, Hungary
2
Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Street, Pécs 7621, Hungary
3
Department of Radiology, Balassa János Teaching Hospital of Tolna County, 5‑7 Béri Balogh Ádám Street, Szekszárd 7100, Hungary
4
Department of Pathology, Balassa János Teaching Hospital of Tolna County, 5‑7 Béri Balogh Ádám Street, Szekszárd 7100, Hungary
5
Department of Biophysics, Medical School, University of Pécs, 12 Szigeti Street, Pécs 7624, Hungary
Rotator cuff arthropathy (RCA) is a common degenerative condition, ultimately leading to need for surgery and total shoulder replacement. The preoperative diagnosis is usually based on the physical findings and imaging procedures, preferably magnetic resonance imaging (MRI) or ultrasound (US) [1]. Since the first shoulder prosthesis developed by Neer in 1955 [2], the s
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