our disclosures on the website. We presented a paper on an EMG study, the typical test we do for shoulder examination, and realized that the champagne toast and the champagne pour position better isolated supraspinatus activity compared to the Jobe test or the empty can test. That study was in healthy volunteers without any shoulder injury or pathology. The tests really haven't been clinically tested, and when we presented it, everybody asked, what does that do for you? Well, we didn't know, it was an EMG test. So we wanted to evaluate the champagne toast and the champagne pour position of manual muscle testings in patients with known pathology, a rotator cuff tear of the supraspinatus. We wanted to see if they had a clinical applicability to test to predict the location or the size of the tear. By location of the supraspinatus, we meant anterior, central, or posterior, or third, or multiple positions, and the size in the anterior, posterior, medial lateral dimensions and area. We also think that the anterior band of the supraspinatus is quite important, and we wanted to see if we could find if it was intact or not intact. It was a prospective observational study on manual muscle testings in adult patients with known full thickness rotator cuff tear. We evaluated the strength and pain for the champagne toast, the pour, the Jobe test, external rotation at the side, and belly press. Interoperative tear size was measured with a graduated probe in the anterior posterior medial lateral dimension. We estimated the location either as anterior, central, posterior, or a combination thereof in the supraspinatus, and we also wanted to know if the anterior band was intact. As you see in the far right, there's a probe, but you can see the biceps tendon, so the anterior band is not intact. Patient demographics, we had 77 shoulders. Average age, as you might imagine, right around 57 or 58 years of age, and 60% male patients. Tear characteristics. In the anterior posterior dimension, the average size, the mean size was 18 millimeters, medial lateral, 14 millimeters. Tear location, as you might imagine, 36% anterior, the most common. 30%, though, were felt to be anterior, central, and posterior, so the entire supraspinatus. Tear shape, we tried to categorize crescent being most common, L-shaped being second most. The other at the bottom were these tears that really hadn't even retracted. They were disinserted, but they didn't have a shape to them. Now, when we looked at our physical exam tests and tear size correlation in the anterior posterior dimension only the champagne pore for pain correlated with anterior posterior dimension. Medial lateral dimension did not have a statistically significant correlation. Physical exam tests and tear size, again, by area, as you might imagine, the champagne pore position, again, with pain correlated with increasing size. Now, the manual muscle test and to try to look at tear location in the anterior band, intact or not intact, interestingly enough, external rotation at the side strength was significantly associated with anterior tear location. There were no other tests that were associated with tear location, and there were no significant results that we could see for the status of the anterior band of the supraspinatus, be it champagne pore or champagne toast position as we see in these photos. Toast and pore, it's easy for patients to understand and put their upper extremity in a consistent position that isolates the activity of the supraspinatus away from the heavy activity of the deltoid and the trapezius that you see in empty can. The trends were that pain and weakness in the pore position was a more anterior lesion. Pain and weakness in the toast position was a more central lesion in the supraspinatus, but they did not reach clinical significance, however. In conclusion, pain in the champagne pore position of manual muscle testing was significantly associated with an increased anterior posterior dimension of the rotator cuff tear, and thus a little bit increase in area. The strength of external rotation of the side trended toward an anterior tear location, and the Job's test was not associated with tear size, location, or status of the anterior band in any statistical way we could figure out. We felt that this was a translational study of physical examination correlated with arthroscopic findings and a known diagnosis of rotator cuff tear. Thank you very much. Thank you.

manual muscle testing

champagne pour position

rotator cuff tear

anterior-posterior dimension

diagnosing rotator cuff tears