背景:虽然肌肉体积增加和肌肉力量增强之间的既定相关性得到了广泛认可,没有研究评估肩关节转移手术中肌肉体积的变化.这项研究旨在评估前上不可修复的肩袖撕裂(ASIRCT)患者的背阔肌和大圆肌腱(aLDTM)肌腱转移中肌肉体积的变化及其临床意义。
方法:本研究回顾性检查了在2018年8月至2022年1月期间接受aLDTM肌腱移植ASIRCT的40例患者。使用ImageJ软件,在T2加权斜轴图像中分割LDTM肌肉,计算即刻和术后1年的总肌肉体积(tLDTMV)。Pearson相关性分析用于确定ΔtLDTMV和ΔASES评分之间的相关性,Δactive-ROM,和Δ强度。
结果:目前的研究显示术后1年tLDTMV增加11.4%。根据术后ASES评分对患者进行分组:第1组(最佳,n=17)和第2组(次优,n=23)。尽管tLDTMVimmediate术后值在组间相似(P=0.954),与第2组相比,第1组的tLDTMV1术后年值明显更高(P=0.021)。在相关分析中,ΔtLDTMV与ΔASES评分呈显著相关(r=0.525,P<0.001),前高程ΔaROM(FE)(r=0.476,P=0.002),ΔaROM的内部旋转(IR)在后面(r=0.398,P=0.011),ΔFE强度(r=0.328,P=0.039),90°外展红外强度Δ(r=0.331,P=0.037),侧IR(r=0.346,P=0.029)。
结论:ASIRCT患者在术后1年观察到tLDTMV显著增加。值得注意的是,更大的ΔtLDTMV表现出与更好的ASES评分的相关性,在FE和IR中都增加了aROM和强度。然而,需要通过采用更强大的标准化测量工具和更大的样本量进行进一步的研究。
BACKGROUND: While the well-established correlation between increased muscle volume and enhanced muscle strength is widely recognized, there have been no studies assessing volumetric muscle changes in transfer surgery in the shoulder. This study aimed to evaluate changes in transferred muscle volume and their clinical implications in anterior latissimus dorsi and teres major (aLDTM) tendon transfer in patients with anterior superior irreparable rotator cuff tears (ASIRCTs).
METHODS: The study retrospectively examined 40 patients who underwent aLDTM tendon transfers for ASIRCTs between August 2018 and January 2022. Using ImageJ software, the LDTM muscle was segmented in T2-weighted oblique axial images, and total muscle volume (tLDTMV) of both immediate and postoperative 1-year were calculated. Pearson correlation analysis was used to determine the correlation between ΔtLDTMV and ΔASES scores, Δactive-ROM, and Δstrength.
RESULTS: The current study revealed an 11.4% increase in tLDTMV at 1-year postoperative. Patients were grouped based on postoperative ASES score: Group 1 (Optimal, n = 17) and Group 2 (Suboptimal, n = 23). Although tLDTMVimmediate postoperative values were similar between groups (P = 0.954), tLDTMV1-year postoperative value was significantly higher in Group 1 compared to Group 2 (P = 0.021). In correlation analysis, ΔtLDTMV showed significant correlations with ΔASES score (r = 0.525, P < 0.001), ΔaROM of forward elevation (FE) (r = 0.476, P = 0.002), ΔaROM of internal rotation (IR) at back (r = 0.398, P = 0.011), Δstrength of FE (r = 0.328, P = 0.039), Δ strength of IR at 90° abduction (r = 0.331, P = 0.037), and IR at side (r = 0.346, P = 0.029).
CONCLUSIONS: Significant increase in tLDTMV was observed at 1-year postoperative for ASIRCT patients. Notably, greater ΔtLDTMV exhibited a correlation with better ASES scores, increased aROM and strength in both FE and IR. Nevertheless, further research is required by employing more robust standardized measurement tools and a larger sample size.