Yoon Jong Pil, Jung Jae Wook, Lee Chang Hwa, Kim Young Gun, Chung Seok Won, Kim Joon Yub, Lee Hyun Joo, Yoon Jee Wook, Lee Hoseok
Orthopedics. 2018 Jan 1;41(1):e15-e21. doi: 10.3928/01477447-20171106-02. Epub 2017 Nov 14.
Fatty degeneration is an important clinical factor in patients with rotator cuff tears. Goutallier grade, occupation ratio, and tangent sign help identify fatty degeneration; however, little is known about how closely these measurement techniques correlate with actual muscle strength deficits. The authors evaluated each method's ability to determine the correlation between fatty degeneration and muscle strength deficits. The authors included 203 patients who underwent full-thickness rotator cuff repair (mean age, 61.29±7.92 years). All patients were evaluated with preoperative magnetic resonance imaging to identify fatty degeneration and with an isokinetic test to determine actual shoulder strength. Fatty degeneration was evaluated using Goutallier grade, occupation ratio, and tangent sign. The actual shoulder strength deficit was evaluated by abduction, whereas external and internal rotation were tested using the isokinetic test. More severe fatty degeneration was correlated with lower degrees of abduction, external rotation, and internal rotation. The occupation ratio was more closely correlated with actual muscle strength deficits. However, in patients with massive tears, the correlation between fatty degeneration and muscle strength was less pronounced. Tangent sign (+) findings had a significantly lower strength of external rotation and abduction. The fatty degeneration of the rotator cuff muscle measured by each method was correlated with actual shoulder strength deficits in patients with rotator cuff tears. However, the correlations were less clear in patients with massive rotator cuff tears. Therefore, in cases of massive rotator cuff tears, fatty degeneration was correlated with muscle strength deficits but was not directly proportional to their extent. [Orthopedics. 2018; 41(1):e15-e21.].
脂肪变性是肩袖撕裂患者的一个重要临床因素。Goutallier分级、占有率和切线征有助于识别脂肪变性；然而，对于这些测量技术与实际肌肉力量 deficits之间的关联程度知之甚少。作者评估了每种方法确定脂肪变性与肌肉力量 deficits之间相关性的能力。作者纳入了203例行全层肩袖修复的患者（平均年龄61.29±7.92岁）。所有患者术前均接受磁共振成像以识别脂肪变性，并进行等速测试以确定实际肩部力量。使用Goutallier分级、占有率和切线征评估脂肪变性。通过外展评估实际肩部力量 deficit，而使用等速测试测试外旋和内旋。更严重的脂肪变性与更低程度的外展、外旋和内旋相关。占有率与实际肌肉力量 deficits的相关性更强。然而，在巨大撕裂的患者中，脂肪变性与肌肉力量之间的相关性不太明显。切线征（+）的患者外旋和外展力量明显较低。每种方法测量的肩袖肌肉脂肪变性与肩袖撕裂患者的实际肩部力量 deficits相关。然而，在巨大肩袖撕裂的患者中，相关性不太明确。因此，在巨大肩袖撕裂的情况下，脂肪变性与肌肉力量 deficits相关，但与它们的程度不成正比。[《骨科》。2018；41（1）：e15 - e21。]
