Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
J Shoulder Elbow Surg. 2019 Dec;28(12):2290-2300. doi: 10.1016/j.jse.2019.04.043. Epub 2019 Jul 13.
There is great current interest in characterizing the prearthroplasty glenohumeral pathoanatomy because of its role in guiding surgical technique and its possible effects on arthroplasty outcome.
We examined 544 patients within 6 weeks before arthroplasty with the goals of characterizing the following: demographic and radiographic characteristics; relationships of the radiographic pathoanatomy to the patient's age, sex, and diagnosis; inter-relationships among glenoid type, glenoid version, and amount of decentering of the humeral head on the glenoid; and relationships of the pathoanatomy to the patient's self-assessed comfort and function.
Male patients had a higher frequency of B2 glenoids and a lower frequency of A2 glenoids. The arthritic shoulders of men were more retroverted and had greater amounts of posterior decentering. Patients with types A1 and C glenoids were younger than those with other glenoid types. Shoulders with osteoarthritis were more likely to be type B2 and to be retroverted. Types B2 and C had the greatest degree of retroversion, whereas types B1 and B2 had the greatest amounts of posterior decentering. Shoulders with glenoid types B1 and B2 and those with more decentering did not have worse self-assessed shoulder comfort and function.
Glenohumeral pathoanatomy was found to have previously unreported relationships to the patient's sex, age, and diagnosis. Contrary to what might have been expected, more advanced glenohumeral pathoanatomy (ie, type B glenoids, greater retroversion, greater decentering) was not associated with worse self-assessed shoulder comfort and function.
由于术前盂肱关节病理解剖结构在指导手术技术方面的重要作用及其对关节置换效果的可能影响，目前人们对其特征分析有着浓厚的兴趣。
我们对 544 例术前 6 周内的患者进行了检查，旨在描述以下内容：人口统计学和影像学特征；影像学病理解剖结构与患者年龄、性别和诊断的关系；肩胛盂形态、肩胛盂倾斜度和肱骨头在肩胛盂上偏心距之间的相互关系；病理解剖结构与患者自我评估舒适度和功能的关系。
男性患者 B2 型肩胛盂的发生率较高，A2 型肩胛盂的发生率较低。男性的关节炎性肩更后倾，且后偏心距更大。A1 和 C 型肩胛盂的患者比其他肩胛盂类型的患者更年轻。骨关节炎性肩更可能是 B2 型和后倾。B2 和 C 型肩胛盂后倾程度最大，而 B1 和 B2 型肩胛盂后偏心距最大。肩胛盂形态为 B1 和 B2 型和偏心距较大的肩，其自我评估的肩部舒适度和功能并没有更差。
我们发现盂肱关节病理解剖结构与患者的性别、年龄和诊断之间存在以前未报道过的关系。与预期相反，更严重的盂肱关节病理解剖结构（即 B 型肩胛盂、更大的后倾、更大的偏心距）与自我评估的肩部舒适度和功能没有更差的相关性。
