■退行性大结节(GT)变化通常与肩袖撕裂有关。然而,关于GT形态学对手术结局的影响知之甚少.这项研究的目的是检查临床和放射学结果之间的关系,肩袖修复后,和GT形态。
■我们回顾性研究了接受关节镜修复的非创伤性全层上/下干裂的肩关节。排除标准是缺乏X光片或磁共振图像,翻修手术,局部修复,并发症,如感染或脱位,随访时间<2年。X线照片上的GT形态分为5组:正常,硬化症,骨刺,粗糙度,女性化。在前后X线片上测量肩关节间隔(AHI)。使用总体脂肪变性指数(GFDI)评估袖带肌肉的脂肪变性。术后2年使用Sugaya分类对术后袖带完整性进行分类。根据日本骨科协会评分和加州大学,洛杉矶肩部评分量表。
■该研究包括212名患者(104名男性和108名女性)的220个肩膀,平均年龄66岁(43-85岁)。平均随访期为28个月(范围,24-60个月)。七肩(3.2%)被列为正常,65(29.5%)为硬化症,55(25.0%)为骨刺,78(34.5%)作为粗糙度,15人(6.8%)为女性化。术前AHI,在粗糙和女性化群体中,显著小于硬化组(P<.01)和骨刺组(P<.001)。粗糙和女性化组有更多的大撕裂(P=.006)。在粗糙和女性化群体中,平均GFDI显著高于硬化组(两者P<.001)。修复的袖带完整性在所有组之间没有差异,分别。日本骨科协会和加州大学,洛杉矶评分从73.3分提高到95.6分,从18.2分提高到34.0分(两者P<0.001),分别,所有组之间没有显著差异,分别。
■GT的粗糙度或女性化与较大的眼泪有关,AHI较小,GFDI较高。在这项研究中,GT粗糙或股骨化的肩部修复的袖带完整性和临床结果不逊于其他类型的GT形态的肩部。关节镜修复术可适用于GT改变的肩部,如果袖带肌肉的脂肪变性不严重。
UNASSIGNED: Degenerative greater tuberosity (GT) changes are often associated with rotator cuff tears. However, little is known about the impact of GT morphology on surgical outcomes. The aim of this study was to examine the relationship between clinical and radiological outcomes, after rotator cuff repair, and GT morphology.
UNASSIGNED: We retrospectively investigated shoulders that underwent arthroscopic repair of nontraumatic full-thickness supra-/infraspinatus tears. The exclusion criteria were a lack of either radiographs or magnetic resonance images, revision surgery, partial repair, complications such as infection or dislocation, and follow-up < 2 years. GT morphology on radiographs was classified into 5 groups: normal, sclerosis, bone spur, roughness, and femoralization. The acromiohumeral interval (AHI) was measured on anteroposterior radiographs. Fatty degeneration of the cuff muscles was evaluated using the global fatty degeneration index (GFDI). Postoperative cuff integrity was classified using Sugaya\'s classification at 2 years after surgery. Clinical outcomes were assessed preoperatively and at postoperative 2 years with the Japanese Orthopaedic Association score and the University of California, Los Angeles shoulder rating scale.
UNASSIGNED: The study included 220 shoulders in 212 patients (104 men and 108 women), with a mean age of 66 years (range 43-85). The mean follow-up period was 28 months (range, 24-60 months). Seven shoulders (3.2%) were classified as normal, 65 (29.5%) as sclerosis, 55 (25.0%) as bone spur, 78 (34.5%) as roughness, and 15 (6.8%) as femoralization. The preoperative AHI, in the roughness and femoralization groups, was significantly smaller than that in the sclerosis (P < .01) and bone spur groups (P < .001). The roughness and femoralization groups had a greater number of large tears (P = .006). In the roughness and femoralization groups, mean GFDI was significantly higher than that in the sclerosis group (P < .001 for both). Repaired cuff integrity was not different between all groups, respectively. Both Japanese Orthopaedic Association and University of California, Los Angeles scores improved postoperatively from 73.3 to 95.6 points and 18.2 to 34.0 points (P < .001 for both), respectively, and there were no significant differences between all groups, respectively.
UNASSIGNED: Roughness or femoralization of the GT was related to larger tears, with smaller AHI and higher GFDI. Repaired cuff integrity and clinical outcomes in shoulders with roughness or femoralization of the GT were not inferior to shoulders with the other types of GT morphologies in this study. Arthroscopic repair can be indicated for shoulders with advanced changes of the GT, if fatty degeneration of the cuff muscles is not severe.