Greater tuberosity morphology is altered in individuals with symptomatic isolated supraspinatus tendon tears.
Greater tuberosity morphology is altered in individuals with symptomatic isolated supraspinatus tendon tears.
复制标题
有症状的孤立性冈上肌腱撕裂的个体大结节形态发生改变。
DOI：
10.1016/j.jse.2023.05.001
复制
发表时间：
2023
影响因子：
3
通讯作者：
Debski,RichardE
中科院分区：
文献类型：
--
作者：
Mattar,LukeT;Popchak,AdamJ;Musahl,Volker;Lin,Albert;Irrgang,JamesJ;Debski,RichardE
研究背景：单纯冈上肌撕裂时，作用于大结节的力减少，可能导致骨性形态学改变。因此，如果大结节的解剖结构改变，诊断或手术识别标志以正确修复撕裂的肌腱可能是困难的。这项研究的目的是评估存在的上级，中间，和下小平面的大结节在个人有症状的孤立冈上肌腱撕裂和撕裂的大小，撕裂的位置和存在的每个facets. MethodsThirty有症状的孤立冈上肌腱撕裂的个人被招募参加这项研究之间的关联。个体对受累肩部进行高分辨率计算机断层扫描，并对图像进行分割以生成每个肱骨的受试者特定模型。识别组成每个小平面的顶点;然而，如果组成小平面的单个顶点丢失，则认为小平面已更改。使用另外2名观察员和5名随机选择的肱骨确定正确识别每个关节面存在的一致性百分比。进行超声检查以评估前后（AP）撕裂大小和撕裂位置。结果参数包括上级、中间和下部关节面的存在; AP撕裂大小;和撕裂位置。点-双相关分析用于确定AP撕裂大小、撕裂位置与上级、中级和低级关节面之间的相关性。距肱二头肌长头后缘1.9- 28.3mm，距肱二头肌长头后缘2.0 ± 4.4mm，距肱二头肌长头后缘0.0- 19.0mm。总体而言，分别有24.3%、29.7%和45.9%的个体的上级、中级和低级关节面没有改变。观察员之间的平均一致率为83.4%。撕裂的大小或撕裂的位置和存在的上级，中间，或下facet（P值范围为0.19至0.74）之间没有发现关联。ConclusionIndividuals有症状的孤立冈上肌撕裂的经验，无论冈上肌撕裂的大小和位置的大结节的骨形态显着改变。该信息对于放射科医生和整形外科医生是有用的，因为改变的解剖结构可能影响在诊断成像或外科手术期间识别重要解剖标志的能力。
BackgroundIn the presence of an isolated supraspinatus tear, the force applied to the greater tuberosity is reduced, which may lead to bony morphologic changes. Thus, diagnostic or surgical identification of landmarks to properly repair the torn tendon might be difficult if the anatomy of the greater tuberosity is altered. The objectives of the study were to assess the presence of the superior, middle, and inferior facets of the greater tuberosity in individuals with symptomatic isolated supraspinatus tendon tears and the associations between tear size, tear location and presence of each facet.MethodsThirty-seven individuals with symptomatic isolated supraspinatus tendon tears were recruited to participate in the study. Individuals underwent a high-resolution computed tomography scan of the involved shoulder and images were segmented to generate subject specific models of each humerus. The vertices comprising each facet were identified; however, if even a single vertex comprising the facet was missing, the facet was considered altered. Percentage agreement for correctly identifying the presence of each facet was determined using 2 additional observers and 5 randomly selected humeri. Ultrasonography was performed to assess anterior-posterior (AP) tear size and tear location. Outcome parameters included presence of the superior, middle, and inferior facets; AP tear size; and tear location. Point-biserial correlations were used to determine the associations between AP tear size, tear location, and presence of the superior, middle, and inferior facets.ResultsSupraspinatus tear size and tear location was 13.1 ± 6.1 mm (range, 1.9-28.3 mm) and 2.0 ± 4.4 mm from the posterior edge of the long head of the biceps tendon (range, 0.0-19.0 mm), respectively. Overall, the superior, middle, and inferior facets were not altered in 24.3%, 29.7%, and 45.9% of individuals, respectively. Percentage agreement between observers was 83.4% on average. No associations were found between tear size or tear location and presence of the superior, middle, or inferior facet (Pvalues ranged from .19 to .74).ConclusionIndividuals with symptomatic isolated supraspinatus tears experience significant alterations in the bony morphology of the greater tuberosity that were irrespective of supraspinatus tear size and location. This information is useful for radiologists and orthopedic surgeons as the altered anatomy may influence the ability to identify important anatomic landmarks during diagnostic imaging or surgical procedures.