Roidis Nikolaos T, Motamed Soheil, Vaishnav Suketu, Ebramzadeh Edward, Karachalios Theofilos S, Itamura John M
Department of Orthopaedics, University of Thessaly, Larissa, Greece.
J Orthop Surg (Hong Kong). 2009 Dec;17(3):331-4. doi: 10.1177/230949900901700318.
To assess the anatomic association of acromioclavicular joint degeneration to supraspinatus outlet impingement and the acromion shape.
Sagittal oblique magnetic resonance images of 49 shoulders in 49 patients were reviewed. 29 of them (mean age, 59 years) underwent surgery for impingement with or without rotator cuff tear (group 1), whereas the 20 controls (mean age, 27 years) were treated for shoulder instability without rotator cuff disease or acromioclavicular joint derangement (group 2). The supraspinatus outlet and the acromion shape of the 2 groups were compared.
The difference in the mean supraspinatus outlet between groups 1 and 2 was 11% (514 vs 577 mm[2], p=0.095) and between the subgroup (of group 1) with full thickness rotator cuff tears and group 2 was 17% (481 vs 577 mm[2], p=0.036). Six of the acromions in group 1 were type III (hooked) compared to none in group 2.
In severe acromioclavicular degeneration, distal clavicular excision is recommended, even in cases with an asymptomatic acromioclavicular joint, so as to prevent further osteophyte formation.
评估肩锁关节退变与冈上肌出口撞击及肩峰形态之间的解剖学关联。
回顾了49例患者49个肩部的矢状斜位磁共振成像。其中29例（平均年龄59岁）因撞击伴或不伴肩袖撕裂接受手术（第1组），而20例对照组（平均年龄27岁）因肩部不稳接受治疗，无肩袖疾病或肩锁关节紊乱（第2组）。比较两组的冈上肌出口和肩峰形态。
第1组和第2组之间平均冈上肌出口的差异为11%（514对577平方毫米，p = 0.095），第1组中伴有全层肩袖撕裂的亚组与第2组之间为17%（481对577平方毫米，p = 0.036）。第1组中有6个肩峰为III型（钩状），而第2组中没有。
在严重的肩锁关节退变中，即使在肩锁关节无症状的情况下，也建议进行锁骨远端切除术，以防止进一步形成骨赘。
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