Glenoid Retroversion Associates With Asymmetric Rotator Cuff Muscle Atrophy in Those With Walch B-type Glenohumeral Osteoarthritis
Glenoid Retroversion Associates With Asymmetric Rotator Cuff Muscle Atrophy in Those With Walch B-type Glenohumeral Osteoarthritis
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DOI：
10.5435/jaaos-d-18-00830
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发表时间：
2020-07-01
影响因子：
3.2
通讯作者：
Tashjian, Robert Z.
中科院分区：
文献类型：
--
作者：
Chalmers, Peter N.;Beck, Lindsay;Tashjian, Robert Z.
背景：我们的目的是确定关节盂后倾是否与偏心盂肱骨关节炎 (GHOA) 中的不对称肩袖肌肉萎缩相关，以及这种不对称是否会导致 GHOA 相关萎缩的恶化。方法：研究两组肩部磁共振图像：年龄大于 50 岁、无肩袖撕裂或 GHOA 的患者（对照组）和解剖型全肩关节置换术术前患者（GHOA 组）。使用可靠且准确的技术测量后倾和肩袖肌肉横截面积。通过除以袖带总面积来创建比例肌肉面积，以纠正患者整体体型的差异。 Walch 等级是通过协商一致确定的。结果：对照组由 102 名患者组成，GHOA 队列由 141 名患者组成。在偏心 GHOA 组中，后倾与冈上肌相对增加（r = 0.268，P= 0.035）、冈下肌增加（r = 0.273，P= 0.032）和肩胛下肌面积减少（r = -0.343，P= 0.006）相关。然而，联合GHOA组的相对肩胛下面积显着高于对照组（P=0.026）。结论：在偏心 GHOA 中，后倾的增加与后袖带相对于前袖带肌肉的体积增加有关，这是同心 GHOA 中前袖带相对于后袖带肌肉的不对称增加体积的逆转。
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.