Department of Biomedical Engineering, The University of Western Ontario, London, ON, Canada; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada.
Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, ON, Canada.
J Shoulder Elbow Surg. 2020 Jan;29(1):167-174. doi: 10.1016/j.jse.2019.05.046. Epub 2019 Aug 28.
Little is known about the cortical-like and cancellous bone density variations in superiorly eroded glenoids due to cuff tear arthropathy. The purpose of this study was to analyze regional bone density in type E2 glenoids.
Clinical shoulder computed tomography scans were obtained from 32 patients with a type E2 superior erosion (10 men and 22 women; mean age, 73 years). Measurement regions were organized into quadrants (superior, inferior, anterior, and posterior) and depth regions. The depth regions were incremented by 2 mm from 0 to 10 mm. A repeated-measures multiple analysis of variance was performed to assess differences and interactions between mean densities (cortical-like and cancellous bone) in each depth, in each quadrant, and between sexes.
The lowest cancellous bone density was found in the inferior glenoid quadrant compared with all other quadrants (307 ± 50 Hounsfield units [HU], P < .001). At the glenoid surface, the superior quadrant contained the highest mean density for cortical-like bone (895 ± 97 HU); this differed significantly from the posterior, anterior, and inferior quadrants (P ≤ .033). As for depth of measurement, cortical-like bone was most dense at the glenoid surface (0-2 mm, 892 ± 91 HU), and density decreased significantly at depths greater than 2 mm (P ≤ .019).
In patients with type E2 glenoids due to cuff tear arthropathy, the densest bone was found in the superior quadrant in the area of erosion. The inferior quadrant, which tends to be unloaded as the humeral head migrates superiorly, had the lowest density bone. In addition, the best-quality bone was located at the glenoid surface as compared with deeper in the vault.
由于肩袖撕裂性关节病，对于上方侵蚀的关节盂，皮质样骨和松质骨密度的变化知之甚少。本研究的目的是分析 E2 型关节盂的区域性骨密度。
从 32 例 E2 型上方侵蚀（10 名男性和 22 名女性；平均年龄 73 岁）的患者中获得临床肩部 CT 扫描。测量区域分为象限（上、下、前、后）和深度区域。深度区域从 0 到 10mm 以 2mm 的增量递增。采用重复测量多元方差分析来评估每个深度、每个象限和性别之间的平均密度（皮质样骨和松质骨）之间的差异和相互作用。
与所有其他象限相比，下关节盂象限的松质骨密度最低（307±50Hounsfield 单位[HU]，P<.001）。在关节盂表面，上象限皮质样骨的平均密度最高（895±97HU）；与后、前和下象限相比，差异有统计学意义（P≤.033）。至于测量深度，皮质样骨在关节盂表面最密集（0-2mm，892±91HU），深度大于 2mm 时密度显著降低（P≤.019）。
在肩袖撕裂性关节病导致的 E2 型关节盂患者中，侵蚀区域的上象限骨质最密。随着肱骨头向上迁移，下象限的负荷减轻，骨质密度最低。此外，与穹顶内的深部相比，关节盂表面的骨质质量最好。
