Terrier A, Ston J, Dewarrat A, Becce F, Farron A
Laboratory of biomechanical orthopedics, école polytechnique fédérale de Lausanne, Station 19, 1015 Lausanne, Switzerland.
Laboratory of biomechanical orthopedics, école polytechnique fédérale de Lausanne, Station 19, 1015 Lausanne, Switzerland.
Orthop Traumatol Surg Res. 2017 Apr;103(2):151-157. doi: 10.1016/j.otsr.2016.12.006. Epub 2017 Jan 4.
Rotator cuff muscle degeneration is an important parameter to consider when planning shoulder arthroplasty.
We hypothesized that rotator cuff muscle degeneration is correlated with scapulohumeral subluxation in patients planned for anatomical total shoulder arthroplasty (TSA).
We developed a semi-automated quantitative CT method to measure rotator cuff muscle degeneration, and retrospectively analyzed 107 preoperative shoulder CT scans of patients with primary osteoarthritis. On a standardized sagittal-oblique CT slice perpendicular to the scapular axis, two observers measured the cross-sectional areas of residual rotator cuff muscle tissues, normalized by the estimated area of healthy muscles. Muscle degeneration was quantified in a semi-automated manner, and divided into atrophy and fatty infiltration. Scapulohumeral subluxation was determined in 3D as the distance between the humeral head center and the glenoid surface center, projected on the same CT slice, and normalized by the humeral head radius. We tested all potential correlations between muscle degeneration and scapulohumeral subluxation.
Muscle degeneration, primarily due to atrophy, predominated in the supraspinatus; it varied from 0.8% to 88.8%. Scapulohumeral subluxation varied from 2.5% to 72.9%, and was mainly in a posterior and postero-superior orientation. There was a significant but weak correlation between the amount of subluxation and both supraspinatus (R=0.207, P=0.032) and infraspinatus (R=0.225, P=0.020) degeneration. Inter- and intra-observer reproducibility of muscle degeneration measurements were both excellent (ICCs range=0.955-0.987 and 0.971-0.988, respectively).
This new semi-automated CT method allows to quantitatively and reproducibly measure rotator cuff muscle degeneration in shoulders with primary osteoarthritis. Muscle degeneration is weakly correlated with scapulohumeral subluxation in patients planned for anatomical TSA.
Level IV.
Diagnostic retrospective study.
在规划肩关节置换术时，肩袖肌退变是一个需要考虑的重要参数。
我们假设在计划进行解剖型全肩关节置换术（TSA）的患者中，肩袖肌退变与肩胛盂肱关节半脱位相关。
我们开发了一种半自动定量CT方法来测量肩袖肌退变，并回顾性分析了107例原发性骨关节炎患者术前的肩部CT扫描图像。在垂直于肩胛轴的标准化矢状斜位CT图像上，两名观察者测量残余肩袖肌组织的横截面积，并通过估计的健康肌肉面积进行标准化。肌肉退变以半自动方式进行量化，并分为萎缩和脂肪浸润。肩胛盂肱关节半脱位在三维空间中被确定为肱骨头中心与肩胛盂表面中心在同一CT图像上的投影距离，并通过肱骨头半径进行标准化。我们测试了肌肉退变与肩胛盂肱关节半脱位之间的所有潜在相关性。
肌肉退变主要由萎缩引起，以上冈肌为主；退变程度从0.8%到88.8%不等。肩胛盂肱关节半脱位程度从2.5%到72.9%不等，主要位于后方和后上方。半脱位程度与冈上肌（R = 0.207，P = 0.032）和冈下肌（R = 0.225，P = 0.020）退变之间存在显著但较弱的相关性。肌肉退变测量的观察者间和观察者内重复性均极佳（组内相关系数范围分别为0.955 - 0.987和0.971 - 0.988）。
这种新的半自动CT方法能够定量且可重复地测量原发性骨关节炎患者肩部的肩袖肌退变。在计划进行解剖型TSA的患者中，肌肉退变与肩胛盂肱关节半脱位之间存在弱相关性。
IV级。
诊断性回顾性研究。
