This retrospective study of 1688 patients with rotator cuff tears defines the timeline over which supraspinatus fatty infiltration and atrophy develop after symptom onset. It asks which factors accelerate these changes and when Stage 2 fatty infiltration and a positive tangent sign appear. Fatty infiltration was graded by Goutallier stage on CT or MRI, and atrophy was measured with the tangent sign.
When counseling a patient with a rotator cuff tear on how long to trial nonoperative care, this paper gives you a temporal roadmap.
Moderate fatty infiltration develops around 3 years after a traumatic tear, and supraspinatus atrophy (positive tangent sign) around 4.5 years. Because Goutallier Stage 2 or higher is irreversible and predicts repair failure, these are practical deadlines rather than abstract data.
The mental model: more tendons torn plus older patient plus longer delay equals faster degeneration. A multi-tendon tear in a 65-year-old is a different urgency than an isolated partial tear in a 45-year-old.
Remember the tangent sign specifics for boards. It is read on the lateral sagittal Y-cut, and it correlates with infraspinatus involvement but not subscapularis. This is a Level IV prognostic study without postoperative outcomes, so it defines timing of degeneration, not repair success itself.
This retrospective study of 1688 patients with rotator cuff tears defines the timeline over which supraspinatus fatty infiltration and atrophy develop after symptom onset. It asks which factors accelerate these changes and when Stage 2 fatty infiltration and a positive tangent sign appear. Fatty infiltration was graded by Goutallier stage on CT or MRI, and atrophy was measured with the tangent sign.
When counseling a patient with a rotator cuff tear on how long to trial nonoperative care, this paper gives you a temporal roadmap.
Moderate fatty infiltration develops around 3 years after a traumatic tear, and supraspinatus atrophy (positive tangent sign) around 4.5 years. Because Goutallier Stage 2 or higher is irreversible and predicts repair failure, these are practical deadlines rather than abstract data.
The mental model: more tendons torn plus older patient plus longer delay equals faster degeneration. A multi-tendon tear in a 65-year-old is a different urgency than an isolated partial tear in a 45-year-old.
Remember the tangent sign specifics for boards. It is read on the lateral sagittal Y-cut, and it correlates with infraspinatus involvement but not subscapularis. This is a Level IV prognostic study without postoperative outcomes, so it defines timing of degeneration, not repair success itself.