Kraljević Marko, Zumstein Valentin, Hügli Rolf, Müller-Gerbl Magdalena
Anatomical Institute, University of Basel, Pestalozzistrasse 20, 4056 Basel, Switzerland.
Surg Radiol Anat. 2013 May;35(4):295-300. doi: 10.1007/s00276-012-1034-8. Epub 2012 Nov 3.
Mineralization distribution of the subchondral bone plate can be used as a marker for long-term stress distribution in diarthrodial joints. Severe injuries or pathological changes of the glenohumeral joint often end in osteoarthritis, where shoulder arthroplasty has become the treatment of choice. The computed tomography osteoabsorptiometry (CT-OAM) is a non-invasive method to determine the distribution of the mineralization of the subchondral bone plate in vivo, which is an important factor concerning the implantation of orthopedic endoprostheses. The aim of this study was to investigate the mineralization of both joint partners of the glenohumeral joint and to compare them with each other.
The distribution of the mineralization of the subchondral bone plate of 57 shoulder specimens was determined by means of CT-OAM. To evaluate a correlation between age and localization of subchondral mineralization maxima, the Chi-square test correlation test was applied.
Forty-nine glenoid cavities (86 %) showed a bicentric mineralization distribution pattern with anterior and posterior maxima, only 8 glenoid cavities (14 %) revealed a monocentric mineralization pattern with anterior maxima. Forty-five humeral heads (79 %) showed a bicentric distribution pattern with anterior and posterior maxima, 12 humeral heads (21 %) could be classified as monocentric with a centro-posterior pronounced maximum.
We could demonstrate that stress distribution in both joint partners of the glenohumeral joint is inhomogeneous and characteristically bicentric due to the physiological incongruity. Monocentric mineralization patterns can result as a cause of age-related loss of incongruity.
软骨下骨板的矿化分布可作为滑膜关节长期应力分布的标志物。盂肱关节的严重损伤或病理变化常导致骨关节炎,此时肩关节置换术已成为首选治疗方法。计算机断层扫描骨吸收测量法(CT-OAM)是一种在体内确定软骨下骨板矿化分布的非侵入性方法,这是与骨科假体植入相关的一个重要因素。本研究的目的是研究盂肱关节两个关节面的矿化情况并相互比较。
通过CT-OAM测定57个肩部标本软骨下骨板的矿化分布。为评估年龄与软骨下矿化最大值定位之间的相关性,应用卡方检验相关性检验。
49个肩胛盂(86%)显示出双中心矿化分布模式,前后有最大值,只有8个肩胛盂(14%)显示出以前方为最大值的单中心矿化模式。45个肱骨头(79%)显示出双中心分布模式,前后有最大值,12个肱骨头(21%)可归类为单中心,中心后方最大值明显。
我们可以证明,由于生理上的不协调,盂肱关节两个关节面的应力分布是不均匀的,且典型地呈双中心。单中心矿化模式可能是与年龄相关的不协调丧失的结果。