Service de chirurgie orthopédique et traumatologique, CHRU de la Cavale Blanche, 29200 Brest, France; Laboratoire de traitement de l'information médicale (LaTIM, UMR1101), bâtiment IBRBS, 22, avenue Camille-Desmoulins, 29200 Brest, France.
IMASCAP®, 29280 Plouzané, France.
Orthop Traumatol Surg Res. 2020 Oct;106(6):1127-1134. doi: 10.1016/j.otsr.2020.06.004. Epub 2020 Aug 15.
Recent studies have shown variations in glenoid bone density in asymmetric wear patterns but have yet to analyze non-arthritic or concentrically worn glenoids.
QUESTIONS/PURPOSES: The purpose of this study is to characterize and compare subchondral glenoid bone densities in both non-arthritic and A1, A2, B1, B2 and B3 osteoarthritic glenoids, as well as to assess uniformity in symmetric and asymmetric erosion wear patterns.
In all, 150 computerized tomography (CT) scans containing equal numbers of non-arthritic (N), A1, A2, B1, B2 and B3 glenoids were segmented semi-automatically. Each reconstructed glenoid was divided first into anterior and posterior quadrants, and then further subdivided into four quadrants. Volumes of interest (VOI) were defined at depths of 0-2.5mm (Zone A), 2.5-5mm (Zone B) and 5-7.5mm (Zone C). Average bone densities were measured at each VOI depth and in each quadrant.
Osteoarthritic glenoids had higher mean bone densities than N glenoids. Mean bone densities were uniform amongst all quadrants for N glenoids, but not for osteoarthritic glenoids. In A1 glenoids, the antero-superior quadrant was less dense in Zone C. A2 glenoids had increased bone density measured posteriorly in Zones B and C. In B1 and B2 glenoids, Zones B and C demonstrated increased bone densities of posterior quadrants compared to anterior quadrants. B3 glenoids presented similar results as A1 and A2 glenoids. Cystic changes were more pronounced in anterior quadrants of A2, B1, B2 and B3 glenoids.
This study demonstrates that osteoarthritic glenoids have greater bone density than non-arthritic glenoids, independent of depth of interest. It also confirms that N glenoids have uniform erosion wear patterns and that B1 and B2 glenoids have irregular wear patterns. It is the first study to reveal that A1, A2 and B3 glenoids, though geometrically symmetrical, have irregular bony densities similar to B2 glenoids. These findings have clinical implications for reaming the glenoid and implant fixation.
Basic Science, Anatomy, Imaging.
最近的研究表明，在不对称性磨损模式中存在肩胛盂骨密度的变化，但尚未分析非关节炎或同心性磨损的肩胛盂。
问题/目的：本研究的目的是描述和比较非关节炎和 A1、A2、B1、B2 和 B3 骨关节炎肩胛盂的亚骺骨密度，并评估对称和不对称性侵蚀性磨损模式的均匀性。
总共对 150 份计算机断层扫描（CT）扫描进行了半自动化分割，其中包含等量的非关节炎（N）、A1、A2、B1、B2 和 B3 肩胛盂。每个重建的肩胛盂首先分为前侧和后侧象限，然后进一步细分为四个象限。在 0-2.5mm（Zone A）、2.5-5mm（Zone B）和 5-7.5mm（Zone C）的深度定义感兴趣容积（VOI）。在每个 VOI 深度和每个象限测量平均骨密度。
骨关节炎肩胛盂的平均骨密度高于 N 肩胛盂。N 肩胛盂的所有象限的平均骨密度均匀，但关节炎肩胛盂则不均匀。在 A1 肩胛盂中，前上象限在 Zone C 中密度较低。A2 肩胛盂在 B 和 C 区的后部骨密度增加。在 B1 和 B2 肩胛盂中，B 和 C 区的后部象限的骨密度高于前侧象限。B3 肩胛盂呈现出与 A1 和 A2 肩胛盂相似的结果。在 A2、B1、B2 和 B3 肩胛盂中，囊性改变在前侧象限更为明显。
本研究表明，关节炎肩胛盂的骨密度高于非关节炎肩胛盂，与感兴趣的深度无关。它还证实，N 肩胛盂具有均匀的侵蚀性磨损模式，而 B1 和 B2 肩胛盂具有不规则的磨损模式。这是第一项表明 A1、A2 和 B3 肩胛盂尽管在几何上是对称的，但具有类似于 B2 肩胛盂的不规则骨密度的研究。这些发现对肩胛盂锉削和植入物固定具有临床意义。
基础科学、解剖学、影像学。
