Ghent University Hospital, De Pintelaan 185, Ghent B-9000, Belgium.
J Orthop Surg Res. 2011 Jan 5;6:1. doi: 10.1186/1749-799X-6-1.
This study evaluates the preoperative conventional anteroposterior radiography and clinical testing in non-operated patients with cuff tear arthropathy. It analyses the radiological findings in relation to the status of the rotator cuff and clinical status as also the clinical testing in relation to the rotator cuff quality. The aim of the study is to define the usefulness of radiography and clinical examination in cuff tear arthropathy.
This study analyses the preoperative radiological (AP-view, (Artro-)CT-scan or MRI-scan) and clinical characteristics (Constant-Murley-score plus active and passive mobility testing) and the peroperative findings in a cohort of 307 patients. These patients were part of a multicenter, retrospective, consecutive study of the French Orthopaedic Society (SOFCOT-2006). All patients had no surgical antecedents and were all treated with prosthetic shoulder surgery for a painful irreparable cuff tear arthropathy (reverse-(84%) or hemi-(8%) or double cup-bipolar prosthesis (8%)).
A positive significancy could be found for the relationship between clinical testing and the rotator cuff quality; between acromiohumeral distance and posterior rotator cuff quality; between femoralization and posterior rotator cuff quality.
A conventional antero-posterior radiograph can not provide any predictive information on the clinical status of the patient. The subscapular muscle can be well tested by the press belly test and the teres minor muscle can be well tested by the hornblower' sign and by the exorotation lag signs. The upward migration index and the presence of femoralization are good indicators for the evaluation of the posterior rotator cuff. An inferior coracoid tip positioning suggests rotator cuff disease.
本研究评估了未手术的肩袖撕裂性关节病患者的术前常规前后位 X 线摄影和临床检查。分析了放射学发现与肩袖状态和临床状态的关系，以及临床检查与肩袖质量的关系。本研究的目的是定义 X 线摄影和临床检查在肩袖撕裂性关节病中的作用。
本研究分析了 307 例患者的术前影像学（AP 视图、（关节）CT 扫描或 MRI 扫描）和临床特征（Constant-Murley 评分加主动和被动活动度测试）以及手术中的发现。这些患者是法国矫形外科协会（SOFCOT-2006）多中心回顾性连续研究的一部分。所有患者均无手术史，均因疼痛性不可修复的肩袖撕裂性关节病（反向[84%]或半肩[8%]或双杯-双极假体[8%]）行人工肩关节置换术治疗。
临床检查与肩袖质量之间、肩峰肱骨头距离与后肩袖质量之间、股骨化与后肩袖质量之间存在显著相关性。
常规前后位 X 线摄影不能提供任何关于患者临床状况的预测信息。通过按压腹部试验可以很好地检查肩胛下肌，通过 Hornblower 征和外旋滞后征可以很好地检查小圆肌。上移指数和股骨化的存在是评估后肩袖的良好指标。喙突尖端位置较低提示肩袖疾病。
