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关键肩角、肩峰指数、肩胛盂版本角和肩峰倾斜角与肩袖撕裂有关。

The critical shoulder angle, the acromial index, the glenoid version angle and the acromial angulation are associated with rotator cuff tears.

机构信息

Department of Orthopedics, Karabuk Safranbolu State Hospital, Atatürk Mah. Sağlık Sok. No 42, 78600, Karabuk, Turkey.

Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2257-2263. doi: 10.1007/s00167-020-06145-8. Epub 2020 Jul 15.

Abstract

PURPOSE

To compare the critical shoulder angle (CSA), acromion index (AI), acromion angulation (AA) and glenoid version angle (GVA) between patients with full-thickness rotator cuff tears (RCTs) and patients with intact rotator cuffs.

METHODS

Between 2014 and 2018, the CSA, AI, AA and GVA were measured in consecutively included patients aged > 40 years who underwent shoulder arthroscopy for full-thickness RCTs. A total of 437 patients with RCTs and a mean age of 51.2 years (± 5.8) were included, 35.7% of whom were male. In the control group, there were n = 433 patients (36.3% male) with an intact rotator cuff, and the mean age was 50.7 years (± 5.3).

RESULTS

The mean AI for the RCT group was 0.7 ± 0.1, which was significantly higher than the mean AI for the control group (0.6 ± 0.1, p < 0.001). The mean CSA for the RCT group was 33.6° ± 3.9°, which was significantly higher than the mean CSA for the control group (31.5° ± 4°, p < 0.001). The mean AA for the RCT group was 13.9° ± 9°, which was significantly higher than the mean AA for the control group (12.4 ± 8.6, p = 0.012). The mean GVA for the RCT group was - 3.5° ± 4.6° and significantly retroverted compared with the mean GVA for the control group (- 2.2° ± 4.6°, p < 0.001). The cutoff values determined by the ROC curve analyses were as follows: 0.6 for AI, 31.4° for CSA, 9.6° for AA and - 2.6° for GVA.

CONCLUSION

The CSA, AI, GVA and AA values measured by MRI were determined to be significantly related to full-thickness rotator cuff ruptures. The AI, CSA, AA and GVA may be considered risk factors for degenerative rotator cuff tears. Assessing the CSA, AI, GVA and AA can be helpful for diagnostic evaluation of patients with full-thickness RCTs.

LEVEL OF EVIDENCE

III.

摘要

目的

比较全层肩袖撕裂(RCTs)患者与肩袖完整患者的临界肩角(CSA)、肩峰指数(AI)、肩峰倾斜角(AA)和关节盂版本角(GVA)。

方法

2014 年至 2018 年间,对连续纳入的年龄>40 岁并接受全层 RCT 肩关节镜检查的患者进行 CSA、AI、AA 和 GVA 测量。共纳入 437 例 RCT 患者,平均年龄 51.2±5.8 岁,其中 35.7%为男性。在对照组中,有 n=433 例肩袖完整患者(36.3%为男性),平均年龄 50.7±5.3 岁。

结果

RCT 组的平均 AI 为 0.7±0.1,明显高于对照组的平均 AI(0.6±0.1,p<0.001)。RCT 组的平均 CSA 为 33.6°±3.9°,明显高于对照组的平均 CSA(31.5°±4°,p<0.001)。RCT 组的平均 AA 为 13.9°±9°,明显高于对照组的平均 AA(12.4°±8.6,p=0.012)。RCT 组的平均 GVA 为-3.5°±4.6°,与对照组的平均 GVA(-2.2°±4.6°)相比明显向后翻转(p<0.001)。ROC 曲线分析确定的截断值如下:AI 为 0.6,CSA 为 31.4°,AA 为 9.6°,GVA 为-2.6°。

结论

MRI 测量的 CSA、AI、GVA 和 AA 值与全层肩袖撕裂明显相关。AI、CSA、AA 和 GVA 可能是退行性肩袖撕裂的危险因素。评估 CSA、AI、GVA 和 AA 有助于全层 RCT 患者的诊断评估。

证据等级

III。

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