McClatchy Samuel G, Heise Griffin M, Mihalko William M, Azar Frederick M, Smith Richard A, Witte Dexter H, Stanfill John G, Throckmorton Thomas W, Brolin Tyler J
Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee, Memphis, USA.
Midsouth Imaging, Germantown, USA.
Shoulder Elbow. 2022 Feb;14(1):24-29. doi: 10.1177/1758573220925046. Epub 2020 May 14.
Deltoid muscle function is paramount to the success of reverse total shoulder arthroplasty. The purpose of this study was to investigate the role of deltoid volume on shoulder range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions.
Retrospective review of records identified 107 patients who met inclusion criteria. The rotator cuff integrity was evaluated by two musculoskeletal-trained radiologists. Volumetric deltoid measurements were calculated from preoperative computed tomography or magnetic resonance imaging scans. Satisfactory outcomes were defined as forward elevation of at least 135°, external rotation of at least 35°, and American Shoulder and Elbow Surgeons and Single Assessment Numerical Evaluation scores of at least 70.
Mean total deltoid muscle volume was significantly higher in patients with satisfactory forward elevation (57.8 ± 18.1 cm³) versus unsatisfactory forward elevation (48.6 ± 19.5 cm³) (p = 0.013). When separated by rotator cuff integrity, total deltoid volume was significantly higher (p = 0.030) in patients who achieved satisfactory forward elevation in the rotator cuff-deficient group but not the rotator cuff-intact group (p = 0.533).
Preoperative deltoid volume directly correlated with achieving satisfactory forward elevation after reverse total shoulder arthroplasty in rotator cuff-deficient conditions and may be one factor in determining the ability to achieve satisfactory outcomes in the rotator cuff-deficient patient.
三角肌功能对于反式全肩关节置换术的成功至关重要。本研究的目的是调查在肩袖完整和肩袖缺损情况下，三角肌体积对反式全肩关节置换术后肩关节活动范围和患者报告结局的作用。
对符合纳入标准的107例患者的记录进行回顾性分析。由两名接受过肌肉骨骼培训的放射科医生评估肩袖完整性。根据术前计算机断层扫描或磁共振成像扫描计算三角肌体积测量值。满意的结局定义为前屈至少135°、外旋至少35°，以及美国肩肘外科医师协会和单评估数值评估得分至少为70分。
前屈满意的患者平均三角肌总体积（57.8±18.1cm³）显著高于前屈不满意的患者（48.6±19.5cm³）（p=0.013）。按肩袖完整性分类时，肩袖缺损组中前屈满意的患者三角肌总体积显著更高（p=0.030），而肩袖完整组则无显著差异（p=0.533）。
术前三角肌体积与肩袖缺损情况下反式全肩关节置换术后实现满意的前屈直接相关，可能是决定肩袖缺损患者能否获得满意结局的一个因素。
