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Abstract：
BACKGROUND: The age-related loss of skeletal muscle mass is an important characteristic of sarcopenia, an increasingly recognized condition with systemic implications. However, its association with shoulder function in elderly patients with rotator cuff tears (RCT) remains unknown. This study aimed to investigate the relationship between low skeletal muscle mass and shoulder function in elderly RCT patients.
METHODS: A retrospective analysis was conducted on RCT patients who underwent chest computed tomography (CT) scans for clinical evaluation. Preoperative CT scan images of the chest were used to calculate the cross-sectional area (CSA) of thoracic muscle at the T4 level. The medical records were reviewed. Shoulder function was assessed using the ASES score and CMS score both preoperatively and at the final follow-up. Data on the preoperative range of motion (ROM) for the affected shoulder, were collected for analysis. Subgroup analyses by sex were also performed.
RESULTS: A total of 283 RCT patients, consisting of 95 males and 188 females, with a mean age of 66.22 ± 4.89(range, 60-95 years) years were included in this retrospective study. The low muscle mass group showed significantly higher level of c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) compared to the normal group(3.75 ± 6.64 mg/L vs. 2.17 ± 2.30 mg/L, p = 0.021; 19.08 ± 12.86 mm/H vs.15.95 ± 10.76 mm/H, p = 0.038; respectively). In the normal group, pre-operative passive ROM, including forward elevation, abduction, lateral rotation, and abductive external rotation, was significantly better than that in the low muscle mass group (127.18 ± 34.87° vs. 89.76 ± 50.61°; 119.83 ± 45.76° vs. 87.16 ± 53.32°; 37.96 ± 28.33° vs. 25.82 ± 27.82°; 47.71 ± 23.56° vs. 30.87 ± 27.76°, all p < 0.01, respectively). Similar results were found in the active ROM of the shoulder. The female low muscle mass group exhibited significantly poorer passive and active ROM (p < 0.05). The post-operative ASES scores and CMS scores of the female low muscle mass group were also statistically worse than those of the female normal group (p < 0.05).
CONCLUSIONS: The results of present study revealed that the low skeletal muscle mass is associated with inferior ROM of the shoulder and per- and post-operative shoulder function, especially for elderly female patients.
METHODS: A retrospective analysis was conducted on RCT patients who underwent chest computed tomography (CT) scans for clinical evaluation. Preoperative CT scan images of the chest were used to calculate the cross-sectional area (CSA) of thoracic muscle at the T4 level. The medical records were reviewed. Shoulder function was assessed using the ASES score and CMS score both preoperatively and at the final follow-up. Data on the preoperative range of motion (ROM) for the affected shoulder, were collected for analysis. Subgroup analyses by sex were also performed.
RESULTS: A total of 283 RCT patients, consisting of 95 males and 188 females, with a mean age of 66.22 ± 4.89(range, 60-95 years) years were included in this retrospective study. The low muscle mass group showed significantly higher level of c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) compared to the normal group(3.75 ± 6.64 mg/L vs. 2.17 ± 2.30 mg/L, p = 0.021; 19.08 ± 12.86 mm/H vs.15.95 ± 10.76 mm/H, p = 0.038; respectively). In the normal group, pre-operative passive ROM, including forward elevation, abduction, lateral rotation, and abductive external rotation, was significantly better than that in the low muscle mass group (127.18 ± 34.87° vs. 89.76 ± 50.61°; 119.83 ± 45.76° vs. 87.16 ± 53.32°; 37.96 ± 28.33° vs. 25.82 ± 27.82°; 47.71 ± 23.56° vs. 30.87 ± 27.76°, all p < 0.01, respectively). Similar results were found in the active ROM of the shoulder. The female low muscle mass group exhibited significantly poorer passive and active ROM (p < 0.05). The post-operative ASES scores and CMS scores of the female low muscle mass group were also statistically worse than those of the female normal group (p < 0.05).
CONCLUSIONS: The results of present study revealed that the low skeletal muscle mass is associated with inferior ROM of the shoulder and per- and post-operative shoulder function, especially for elderly female patients.
摘要：
背景：与年龄相关的骨骼肌质量损失是少肌症的重要特征，一个日益公认的具有系统性影响的条件。然而,其与肩袖撕裂(RCT)老年患者肩关节功能的相关性尚不清楚.本研究旨在探讨老年RCT患者低骨骼肌质量与肩关节功能的关系。
方法：对接受胸部计算机断层扫描（CT）扫描进行临床评估的RCT患者进行回顾性分析。术前胸部CT扫描图像用于计算T4水平胸肌的横截面积（CSA）。审查了医疗记录。术前和最后随访时使用ASES评分和CMS评分评估肩功能。受累肩关节的术前活动范围（ROM）数据，收集用于分析。还进行了按性别的亚组分析。
结果：总共283例RCT患者，由95名男性和188名女性组成，平均年龄66.22±4.89(范围，60-95岁）年被纳入这项回顾性研究。与正常组相比，低肌肉质量组的C反应蛋白（CRP）和红细胞沉降率（ESR）水平显着升高（3.75±6.64mg/Lvs.2.17±2.30mg/L，p=0.021;19.08±12.86mm/Hvs.15.95±10.76mm/H,p=0.038；分别）。在正常组,术前被动ROM，包括向前高程，绑架,横向旋转,和外旋，明显优于低肌肉质量组（127.18±34.87°vs.89.76±50.61°;119.83±45.76°vs.87.16±53.32°;37.96±28.33°vs.25.82±27.82°;47.71±23.56°vs.30.87±27.76°,所有p分别<0.01)。在肩部的活动ROM中发现了类似的结果。女性低肌肉质量组表现出明显较差的被动和主动ROM（p<0.05）。女性低肌量组的术后ASES评分和CMS评分也比女性正常组差别性有统计学意义(p<0.05)。
结论：本研究结果表明，低骨骼肌质量与肩关节下ROM和手术前后肩关节功能有关，尤其是老年女性患者。
方法：对接受胸部计算机断层扫描（CT）扫描进行临床评估的RCT患者进行回顾性分析。术前胸部CT扫描图像用于计算T4水平胸肌的横截面积（CSA）。审查了医疗记录。术前和最后随访时使用ASES评分和CMS评分评估肩功能。受累肩关节的术前活动范围（ROM）数据，收集用于分析。还进行了按性别的亚组分析。
结果：总共283例RCT患者，由95名男性和188名女性组成，平均年龄66.22±4.89(范围，60-95岁）年被纳入这项回顾性研究。与正常组相比，低肌肉质量组的C反应蛋白（CRP）和红细胞沉降率（ESR）水平显着升高（3.75±6.64mg/Lvs.2.17±2.30mg/L，p=0.021;19.08±12.86mm/Hvs.15.95±10.76mm/H,p=0.038；分别）。在正常组,术前被动ROM，包括向前高程，绑架,横向旋转,和外旋，明显优于低肌肉质量组（127.18±34.87°vs.89.76±50.61°;119.83±45.76°vs.87.16±53.32°;37.96±28.33°vs.25.82±27.82°;47.71±23.56°vs.30.87±27.76°,所有p分别<0.01)。在肩部的活动ROM中发现了类似的结果。女性低肌肉质量组表现出明显较差的被动和主动ROM（p<0.05）。女性低肌量组的术后ASES评分和CMS评分也比女性正常组差别性有统计学意义(p<0.05)。
结论：本研究结果表明，低骨骼肌质量与肩关节下ROM和手术前后肩关节功能有关，尤其是老年女性患者。
