Mendez Gregory M, Manske Robert C, Smith Barbara S, Prohaska Daniel J
Department of Orthopaedics, University of Kansas School of Medicine, Wichita, KS.
Department of Physical Therapy, Wichita State University, Wichita, KS.
Kans J Med. 2022 May 17;15(2):155-159. doi: 10.17161/kjm.vol15.16343. eCollection 2022.
The purpose of this study was to investigate the relationships between supraspinatus atrophy on magnetic resonance imaging (MRI) and other objective parameters in patients with rotator cuff tears. It was hypothesized that high-grade supraspinatus fatty infiltration would be correlated negatively with handgrip strength, shoulder strength, and patient-reported outcome measures (PROMs).
Patients with MRI-proven rotator cuff tears treated by a single sports medicine fellowship-trained orthopaedist at a single institution underwent comprehensive preoperative evaluation including bilateral handgrip and shoulder strength measurements with dynamometers and multiple online questionnaires from the Surgical Outcomes SystemTM (Arthrex, Naples, FL). Available shoulder MRIs were reviewed to grade supraspinatus fatty infiltration severity according to the 5-tier Goutallier system and an alternate 3-tier classification scheme. Difference analysis and Spearman (rho) rank order correlation were applied to the collected data to define the relationships between supraspinatus fatty infiltration and key variables including handgrip strength, shoulder strength, and scores derived from the shoulder PROMs.
Ninety of the 121 patients enrolled in the study had shoulder MRIs available for review. There was no correlation found between supraspinatus fatty infiltration and handgrip strength, shoulder abduction strength, or any of the seven common shoulder PROM scores evaluated. There was statistically significant, albeit weak, correlation between MRI-derived fatty infiltration and shoulder external rotation strength.
Contrary to the hypothesis, high-grade supraspinatus fatty infiltration is largely unrelated to and should not be considered predictive of handgrip strength, shoulder strength, or common shoulder PROM scores.
本研究的目的是调查磁共振成像(MRI)上冈上肌萎缩与肩袖损伤患者其他客观参数之间的关系。研究假设是,高级别的冈上肌脂肪浸润与握力、肩部力量以及患者报告的结局指标(PROMs)呈负相关。
在单一机构接受一名运动医学专科培训的骨科医生治疗的经MRI证实为肩袖损伤的患者,接受了全面的术前评估,包括使用测力计进行双侧握力和肩部力量测量,以及来自手术结局系统TM(Arthrex,那不勒斯,佛罗里达州)的多个在线问卷。对现有的肩部MRI进行回顾,根据5级Goutallier系统和另一种3级分类方案对冈上肌脂肪浸润严重程度进行分级。对收集的数据进行差异分析和Spearman(rho)等级相关分析,以确定冈上肌脂肪浸润与关键变量之间的关系,这些变量包括握力、肩部力量以及从肩部PROMs得出的分数。
该研究纳入的121名患者中有90名患者的肩部MRI可供回顾。未发现冈上肌脂肪浸润与握力、肩外展力量或所评估的七个常见肩部PROM分数中的任何一个之间存在相关性。MRI得出的脂肪浸润与肩部外旋力量之间存在统计学上显著但较弱的相关性。
与假设相反,高级别的冈上肌脂肪浸润在很大程度上与握力、肩部力量或常见肩部PROM分数无关,不应被视为这些指标的预测因素。