Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears
Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears
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DOI：
10.1007/s00167-014-3499-y
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发表时间：
2016-07-01
影响因子：
3.8
通讯作者：
Banerjee, Marc
中科院分区：
文献类型：
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作者：
Balke, Maurice;Liem, Dennis;Banerjee, Marc
肩峰形态的独特特征似乎是退行性冈上肌腱撕裂发展的因素之一。因此，外伤性肌腱撕裂患者是否也存在这些参数值得怀疑。本研究假设退行性冈上肌腱撕裂患者的肩峰形态与外伤性撕裂患者不同。本研究纳入了2010年至2013年接受关节镜下肩袖修复术的136例患者。 72 名患者患有退行性病变（第 1 组），64 名患者患有外伤性冈上肌腱撕裂（第 2 组）。在术前X光片上测量了Bigliani类型、肩峰斜度、肩峰距离、肩峰外侧角（LAA）、肩峰指数（AI）和临界肩角（CSA）。使用 t 检验比较这些参数的中位数以及两组的年龄。Bigliani 类型的百分比分布不同（第 1 组与第 2 组：1 型：18/38，2 型：56/55，3 型：26/8）。所有参数均显示退行性撕裂和创伤性撕裂之间存在显着差异。斜率：21.2A 度（SD 7.6A 度）与 19.2A 度（SD 7.9A 度，p = 0.026），AH 距离：8.4 毫米（SD 2.3 毫米）与 9.9 毫米（SD 1.9 毫米，p = 0.0006），LAA：77.0A 度（SD 4.0A 度）与 82.5A 度（SD 4.7A 度，p < 0.0001），AI：0.77（SD 0.07）与 0.73（0.06，p = 0.0239），CSA：36.8A 度（SD 3.6A 度）与 35.3A 度（SD 2.9A 度，p = 0.007）。 LAA < 70A 度或 AH 距离 < 5 mm 仅发生在退行性撕裂中。退行性撕裂患者的年龄明显较大（60 岁与 54 岁）。退行性冈上肌腱撕裂患者的肩峰形态与外伤性撕裂患者不同的假设得到了证实。与外伤性撕裂相比，退行性撕裂的肩膀显示出更窄的肩峰下空间和更大的横向延伸以及更陡峭的肩峰角度。因此，本研究的结果支持外部撞击是导致退行性肩袖撕裂的原因的理论。
Distinct characteristics of acromial morphology seem to be one factor for the development of degenerative supraspinatus tendon tears. Thus, it is questionable whether patients with traumatic tendon tears also present these parameters. The hypothesis of the present study was that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears.One hundred and thirty-six patients that were treated by arthroscopic rotator cuff repair from 2010 to 2013 were included in this study. Seventy-two patients had degenerative (group 1), and 64 had traumatic (group 2) supraspinatus tendon tears. On preoperative radiographs the Bigliani type, acromial slope, acromiohumeral (AH) distance, lateral acromial angle (LAA), acromion index (AI), and critical shoulder angle (CSA) were measured. Medians of these parameters as well as of age of both groups were compared using the t test.The percentaged distribution of the Bigliani type differed (group 1 vs. 2: type 1: 18/38, type 2: 56/55, type 3: 26/8). All parameters showed significant differences between degenerative and traumatic tears. Slope: 21.2A degrees (SD 7.6A degrees) versus 19.2A degrees (SD 7.9A degrees, p = 0.026), AH distance: 8.4 mm (SD 2.3 mm) versus 9.9 mm (SD 1.9 mm, p = 0.0006), LAA: 77.0A degrees (SD 4.0A degrees) versus 82.5A degrees (SD 4.7A degrees, p < 0.0001), AI: 0.77 (SD 0.07) versus 0.73 (0.06, p = 0.0239), and CSA: 36.8A degrees (SD 3.6A degrees) versus 35.3A degrees (SD 2.9A degrees, p = 0.007). An LAA < 70A degrees or an AH distance of < 5 mm only occurred in degenerative tears. Patients with degenerative tears were significantly older (60 vs. 54 years).The hypothesis that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears was confirmed. Shoulders with degenerative tears show a narrower subacromial space and a larger lateral extension as well as a steeper angulation of the acromion than with traumatic tears. Thus, the results of this study support the theory of external impingement as a cause for degenerative rotator cuff tears.IV.