DSC examination of rotator cuff damage in patients with total shoulder arthroplasty

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-scan-based 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.