Service de chirurgie orthopédique 1, hopital Roger-Salengro, centre hospitalier régional universitaire, 59037 Lille, France.
Service de chirurgie orthopédique 1, hopital Roger-Salengro, centre hospitalier régional universitaire, 59037 Lille, France.
Orthop Traumatol Surg Res. 2021 Jun;107(4):102902. doi: 10.1016/j.otsr.2021.102902. Epub 2021 Mar 26.
The teres minor (TM) participates in active external rotation (ER) after reverse shoulder arthroplasty (RSA). The TM index of trophicity (T2/G) measured on CT scan is a predictor of poor results in patients who have irreparable rotator cuff tears. The aim of this study was to evaluate how T2/G impacts the functional outcomes of RSA in the context of massive rotator cuff tears. We hypothesized that a T2/G less than 0.75 is a predictor of worse functional outcomes.
This study involved 32 shoulders in 26 patients (mean age 71 years) who underwent RSA for cuff tear arthropathy and had a minimum follow-up of 1 year (mean 3 years). T2/G is the ratio between T2 (TM thickness) and G (maximum glenoid cavity thickness) on preoperative axial CT slices. Clinical examination at the final assessment involved determining the Constant score, the shoulder joint's range of motion and the Subjective Shoulder Value (SSV).
Eight shoulders had a T2/G of less than 0.75 (group 1) while 24 shoulders had an index above 0.75 (group 2). These two groups were similar preoperatively. The Constant-Murley score in group 1 was significantly lower than in group 2 (50.2 points versus 59.7 points, p<0.05). Group 1 had a postoperative improvement of 1̊ in their ER with elbow at side while group 2 had a 16.5̊ improvement (p=0.002). Group 1 had a postoperative loss of 6.3̊ in their ER in 90̊ abduction while group 2 had a 21.7̊ improvement (p=0.001). The SSV at the final assessment was 69% in group 1 versus 79% in group 2 (p=0.094).
Having a TM index of trophicity below 0.75 is a negative predictor of clinical outcomes due to lack of ER after RSA.
IV.
冈下肌（TM）在反肩关节置换（RSA）后参与主动外旋（ER）。CT 扫描上测量的 TM 营养指数（T2/G）是预测肩袖不可修复撕裂患者预后不良的指标。本研究旨在评估在巨大肩袖撕裂的情况下，T2/G 对 RSA 功能结果的影响。我们假设 T2/G 小于 0.75 是功能结果较差的预测指标。
这项研究涉及 26 名患者的 32 个肩部（平均年龄 71 岁），这些患者因肩袖撕裂性关节炎接受 RSA 治疗，随访时间至少为 1 年（平均 3 年）。T2/G 是术前轴位 CT 切片上 T2（TM 厚度）和 G（最大肩胛盂厚度）之间的比值。最终评估时的临床检查包括确定 Constant 评分、肩关节活动范围和主观肩部值（SSV）。
8 个肩部的 T2/G 小于 0.75（组 1），24 个肩部的 T2/G 大于 0.75（组 2）。这两组在术前相似。组 1 的 Constant-Murley 评分明显低于组 2（50.2 分比 59.7 分，p<0.05）。组 1 在肘部位于体侧时 ER 术后改善了 1°，而组 2 改善了 16.5°（p=0.002）。组 1 在 90°外展时 ER 术后丧失了 6.3°，而组 2 改善了 21.7°（p=0.001）。组 1 的最终 SSV 为 69%，组 2 为 79%（p=0.094）。
TM 营养指数低于 0.75 是 RSA 后 ER 缺乏的临床结果的负预测指标。
IV。
