Walch b型肩胛骨关节炎患者肩关节后倾与不对称肩袖肌萎缩相关。

P. Chalmers, L. Beck, Matthew D Miller, Irene Stertz, Heath B. Henninger, R. Tashjian
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引用次数: 9

摘要

背景:我们的目的是确定偏心型盂肱骨关节炎(GHOA)患者的盂后翻是否与不对称肩袖肌萎缩有关,以及这种不对称是否会加重GHOA相关的萎缩。方法对50岁以上无肩袖撕裂或无高肩关节置换术患者(对照组)和术前解剖全肩关节置换术患者(高肩关节置换术组)肩关节磁共振图像进行研究。使用可靠和准确的技术测量后倾和肩袖肌横截面积。比例肌肉面积通过除以总袖带面积来纠正患者整体尺寸的差异。沃尔什的分数是通过协商一致的方式分配的。结果对照组102例,GHOA组141例。在偏心性GHOA组中,脊柱后倾与冈上肌相对增加(r = 0.268, P = 0.035)、冈下肌相对增加(r = 0.273, P = 0.032)、肩胛下肌相对减少(r = -0.343, P = 0.006)相关。而联合GHOA组肩胛下肌相对面积明显高于对照组(P = 0.026)。结论在偏心型高置换术中,后袖相对于前袖肌肉的体积增加与后袖的后倾程度增加有关,这与同心型高置换术中前袖相对于后袖肌肉的体积不对称增加是相反的。证据等级:诊断性,III级。
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Glenoid Retroversion Associates With Asymmetric Rotator Cuff Muscle Atrophy in Those With Walch B-type Glenohumeral Osteoarthritis.
BACKGROUND Our purpose was to determine whether glenoid retroversion associates with asymmetric rotator cuff muscle atrophy in eccentric glenohumeral osteoarthritis (GHOA) and if this asymmetry is worsening of GHOA-related atrophy. METHODS Two groups of shoulder magnetic resonance images were studied: patients older than 50 years without a rotator cuff tear or GHOA (control group) and patients preoperative to anatomic total shoulder arthroplasty (GHOA group). Retroversion and rotator cuff muscle cross-sectional areas were measured using reliable and accurate techniques. Proportional muscle areas were created by dividing by total cuff area to correct for differences in overall patient size. Walch grades were assigned via consensus. RESULTS The control group consisted of 102 patients and the GHOA cohort consisted of 141 patients. Within the eccentric GHOA group, retroversion associated with relative increasing supraspinatus (r = 0.268, P = 0.035), increasing infraspinatus (r = 0.273, P = 0.032), and decreasing subscapularis areas (r = -0.343, P = 0.006). However, the combined GHOA group had a significantly higher relative subscapularis area than the control group (P = 0.026). CONCLUSION In the eccentric GHOA, increasing retroversion is associated with increasing volume of the posterior cuff relative to the anterior cuff muscles, which is a reversal of the asymmetric increasing volume of the anterior cuff relative to the posterior cuff muscles seen with concentric GHOA. LEVEL OF EVIDENCE Diagnostic, level III.
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