Department of Rehabilitation, Nobuhara Hospital, Hyogo, Japan; Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Institute of Biomechanics, Nobuhara Hospital, Hyogo, Japan.
J Shoulder Elbow Surg. 2020 Oct;29(10):2043-2050. doi: 10.1016/j.jse.2020.02.017. Epub 2020 May 26.
The purpose of this study was to demonstrate the differences in shoulder muscle strength, cross-sectional area of the rotator cuff muscles, acromiohumeral distance, and supraspinatus tendon thickness between symptomatic and asymptomatic patients with rotator cuff tears.
Thirty-two symptomatic patients and 23 asymptomatic patients with rotator cuff tears participated in this study. Data of the patients with any type of tear and supraspinatus tear were analyzed. We evaluated the isometric torque, cross-sectional area of the rotator cuff muscles, supraspinatus tendon thickness, acromiohumeral distance, range of motion, and Western Ontario Rotator Cuff Index.
Asymptomatic patients showed greater isometric torque of shoulder abduction and internal rotation than symptomatic patients with any type of tear (P ≤ .01). Asymptomatic patients also demonstrated greater cross-sectional area of the supraspinatus (P < .01); however, there was no significant difference in the cross-sectional area of the other cuff muscles. There was also no significant difference in the supraspinatus tendon thickness (P = .10). The acromiohumeral distance at 90° of shoulder abduction was larger (P = .04) in asymptomatic patients. Additionally, similar tendencies were observed in the results of patients with supraspinatus tears, except for the isometric torque of shoulder external rotation. This torque was greater (P < .01) in asymptomatic patients.
Asymptomatic patients showed greater shoulder range of motion, muscle strength of shoulder abduction and internal rotation, small occupation ratio of supraspinatus tendon thickness as a percentage of acromiohumeral distance, and large cross-sectional area of supraspinatus.
本研究旨在展示肩袖撕裂患者中症状性和无症状性患者的肩部肌肉力量、肩袖肌肉横截面积、肩峰肱骨关节距离和冈上肌腱厚度的差异。
本研究纳入 32 例症状性肩袖撕裂患者和 23 例无症状性肩袖撕裂患者。分析了所有类型肩袖撕裂和冈上肌腱撕裂患者的数据。我们评估了等长扭矩、肩袖肌肉横截面积、冈上肌腱厚度、肩峰肱骨关节距离、活动范围和 Western Ontario Rotator Cuff 指数。
无症状患者的肩外展和内旋等长扭矩均大于任何类型肩袖撕裂的症状性患者(P≤.01)。无症状患者的冈上肌横截面积也较大(P<.01);然而,其他肩袖肌肉的横截面积无显著差异。冈上肌腱厚度也无显著差异(P=.10)。肩外展 90°时的肩峰肱骨关节距离在无症状患者中较大(P=.04)。此外,在冈上肌腱撕裂患者的结果中也观察到了类似的趋势,除了肩外旋的等长扭矩。无症状患者的扭矩较大(P<.01)。
无症状患者的肩部活动范围更大,肩外展和内旋的肌肉力量更大,冈上肌腱厚度与肩峰肱骨关节距离的比例较小,冈上肌横截面积较大。