Bezirgan Ugur, Yogun Yener, Bozkurt Orhun Eray, Dumlupinar Ebru, Armangil Mehmet
Faculty of Medicine, Orthopedics and Traumatology Department, Hand Surgery Unit, Ankara University, Ankara, Turkey.
Faculty of Medicine, Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey.
Shoulder Elbow. 2025 Jan;17(1):77-85. doi: 10.1177/17585732231224255. Epub 2024 Jan 3.
Shoulder function is important in patients who underwent reverse shoulder prosthesis surgery for cuff tear arthropathy in the postoperative period to implement their daily routines. Therefore, we aimed to predict the repairability of the subscapularis tendon in reverse shoulder arthroplasty by looking at the radiological findings. A total of 107 shoulders of 101 patients were examined retrospectively. Preoperative and postoperative shoulder AP radiographs of the patients were evaluated according to acromiohumeral distance, lateral humeral offset, acromiohumeral distance difference, lateral humeral offset difference, Hamada classification, and rotator cuff Goutallier staging. The subscapularis tendon could not be repaired in 31 (28.97%) of 107 shoulders and could not be repaired in 13 of 17 patients who used an onlay prosthesis. There was no significant correlation between preoperative Hamada staging, preoperative lateral humeral offset and lateral humeral offset difference, and subscapularis repair ( < 0.05). Preoperative and postoperative acromiohumeral distance cut-off values were found to be 0.59 and 3.22 cm, respectively. A statistically significant correlation was found in terms of preoperative acromiohumeral distance, postoperative acromiohumeral distance, acromiohumeral distance difference, Goutallier stage with the repair of subscapularis tendon. Fatty atrophy in rotator cuff muscles and distalization of the humerus can be considered as negative predictive values in terms of repairability of the subscapularis tendon.
对于因肩袖撕裂性关节病接受反式肩关节置换手术的患者而言，术后肩部功能对其日常生活十分重要。因此，我们旨在通过观察影像学表现来预测反式肩关节置换术中肩胛下肌腱的可修复性。我们对101例患者的107个肩部进行了回顾性研究。根据肩峰肱骨头距离、肱骨外侧偏移、肩峰肱骨头距离差值、肱骨外侧偏移差值、滨田分类法以及肩袖痛风利埃分期对患者术前和术后的肩关节前后位X线片进行评估。107个肩部中有31个（28.97%）的肩胛下肌腱无法修复，在17例使用补片假体的患者中，有13例的肩胛下肌腱无法修复。术前滨田分期、术前肱骨外侧偏移及肱骨外侧偏移差值与肩胛下肌修复情况之间无显著相关性（<0.05）。术前和术后肩峰肱骨头距离的临界值分别为0.59和3.22 cm。就术前肩峰肱骨头距离、术后肩峰肱骨头距离、肩峰肱骨头距离差值、痛风利埃分期与肩胛下肌腱修复情况而言，发现存在统计学显著相关性。肩袖肌肉中的脂肪萎缩和肱骨远端移位可被视为肩胛下肌腱可修复性的阴性预测指标。
