Schulz C U, Maier M, Glaser C, Anetzberger H, Müller-Gerbl M
Orthopädische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Z Orthop Ihre Grenzgeb. 2006 May-Jun;144(3):311-5. doi: 10.1055/s-2006-933447.
Based on hypothesis that calcific tendonitis of the supraspinatus tendon (CTSSP) could be associated with glenohumeral imbalance, glenohumeral stress distribution was analyzed.
26 patient shoulders with CTSSP, unsuccessfully treated by non-operative measures, were examined. A group of 26 macroscopically normal shoulder specimens served as controls. Analysis of glenohumeral stress distribution was indirect evaluating glenoid subchondral bone mineralization by computed tomography osteoabsorptiometry. Density distribution of glenoid subchondral bone mineralization and the position of the two most frequent density maxima were analyzed.
Patterns of subchondral mineralization and position of the anterior density maximum were significantly different between both groups. CTSSP mostly presented with a monocentric, anteriorly increased mineralization indicative for a regional increase of stress. The inferior shift of the anterior density maximum demonstrates a parallel shift of glenohumeral stress distribution.
Mineralization patterns indicate that glenohumeral stress distribution is not physiologic in CTSSP. Moreover, it is comparable with glenohumeral stress distribution as observed in atraumatic antero-inferior glenohumeral instability. Relevance of this observation should be proven for etiology of CTSSP.
基于肩峰下肌腱钙化性肌腱炎（CTSSP）可能与盂肱关节失衡相关的假设，分析盂肱关节应力分布。
对26例经非手术治疗无效的CTSSP患者的肩部进行检查。选取26个宏观正常的肩部标本作为对照组。通过计算机断层扫描骨吸收测定法间接评估盂肱关节应力分布，即评估肩胛盂软骨下骨矿化情况。分析肩胛盂软骨下骨矿化的密度分布以及两个最常见密度最大值的位置。
两组之间软骨下矿化模式和前密度最大值的位置存在显著差异。CTSSP大多表现为单中心、前部矿化增加，提示局部应力增加。前密度最大值的下移表明盂肱关节应力分布发生了平行移动。
矿化模式表明CTSSP中盂肱关节应力分布不符合生理情况。此外，它与非创伤性前下盂肱关节不稳中观察到的盂肱关节应力分布相似。这一观察结果与CTSSP病因的相关性有待证实。
