• Full Name: CHONLATHAN BOONTAN
• Affiliation/Institution: Medical Correctional Institution
• Country: Thailand

• Full Name: JIRANTANIN RATTANAVARINCHAI
• Affiliation/Institution: Police General hospital
• Country: Thailand

• Full Name: THAWORN SISAYANARANE
• Affiliation/Institution: Police General hospital
• Country: Thailand

• Full Name: KANIN LUMDEE
• Affiliation/Institution: Police General hospital
• Country: Thailand

• Full Name: SURAPHOL KESPRAYURA
• Affiliation/Institution: Police General hospital
• Country: Thailand

• Full Name: NATTHICHA SAOWATANPONG
• Affiliation/Institution: Police General hospital
• Country: Thailand

Background

Sarcopenia is an age-related syndrome characterized by progressive loss of skeletal muscle mass and strength, resulting in musculoskeletal fragility and functional decline. Degenerative rotator cuff tears are common in elderly and frequently demonstrate fatty infiltration, as classified by the  Goutallier. Although sarcopenia and rotator cuff degeneration share overlapping risks, their association remains unclear. This study aimed to investigate the correlation between sarcopenia and rotator cuff muscle fatty infiltration in degenerative rotator cuff tear patients.

Methods

This single-center cross-sectional study included patients aged ≥55 years with degenerative rotator cuff tears confirmed by magnetic resonance imaging. Sarcopenia was diagnosed based on low handgrip strength measured using a Jamar dynamometer and reduced appendicular skeletal muscle mass assessed by bioelectrical impedance analysis. Rotator cuff muscle fatty infiltration was graded according to the Goutallier classification. Tendon retraction (Patte classification), muscle atrophy (Warner classification), and tear size were evaluated. Demographic variables and comorbidities were recorded. Multivariate logistic regression analysis was performed to identify factors independently associated with sarcopenia.

Results

The study enrolled 168 patients. 44 patients(26.2%) demonstrated high-grade fatty infiltration (Goutallier grade 3–4). Patients with high-grade Goutallier were older and had higher body mass index, as well as prevalence of diabetes and hypertension (p < 0.01). Sarcopenia was identified in 22 patients (13.1%), and 77.3% of these exhibited Goutallier grade 3–4. After adjustment for age, BMI, diabetes, and hypertension, high-grade fatty infiltration remained independently associated with sarcopenia (adjusted odds ratio, 6.96; 95% confidence interval, 2.06–23.46; p = 0.002).

Conclusions

In degenerative rotator cuff tear patients, high-grade fatty infiltration is strongly associated with sarcopenia. These findings suggest that advanced local rotator cuff degeneration reflects systemic muscle loss, highlighting the importance of sarcopenia assessment in elderly with high Goutallier grades.