期刊
BONE & JOINT OPEN
卷 2, 期 7, 页码 552-561出版社
BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/2633-1462.27.BJO-2021-0081.R1
关键词
rotator cuff muscle; muscle volume; 3D CT scan; atrophy; fatty infiltration; volumetric analysis; tangent sign; occupation ratio; shoulder arthroplasty
类别
This study found that rotator cuff muscle volume is significantly decreased in patients with OA, CTA, or IRCT compared to healthy patients, with minimal differences observed between the different pathological groups. The influence of rotator cuff muscle volume and atrophy on outcome may be overestimated.
Aims The aim of this study was to describe a quantitative 3D CT method to measure rotator cuff muscle volume, atrophy, and balance in healthy controls and in three pathological shoulder cohorts. Methods In all, 102 CT scans were included in the analysis: 46 healthy, 21 cuff tear arthropathy (CTA), 18 irreparable rotator cuff tear (IRCT), and 17 primary osteoarthritis (OA). The four rotator cuff muscles were manually segmented and their volume, including intramuscular fat, was calculated. The normalized volume (NV) of each muscle was calculated by dividing muscle volume to the patient's scapular bone volume. Muscle volume and percentage of muscle atrophy were compared between muscles and between cohorts. Results Rotator cuff muscle volume was significantly decreased in patients with OA, CTA, and IRCT compared to healthy patients (p < 0.0001). Atrophy was comparable for all muscles between CTA, IRCT, and OA patients, except for the supraspinatus, which was significantly more atrophied in CTA and IRCT (p = 0.002). In healthy shoulders, the anterior cuff represented 45% of the entire cuff, while the posterior cuff represented 40%. A similar partition between anterior and posterior cuff was also found in both CTA and IRCT patients. However, in OA patients, the relative volume of the anterior (42%) and posterior cuff (45%) were similar. Conclusion This study shows that rotator cuff muscle volume is significantly decreased in patients with OA, CTA, or IRCT compared to healthy patients, but that only minimal differences can be observed between the different pathological groups. This suggests that the influence of rotator cuff muscle volume and atrophy (including intramuscular fat) as an independent factor of outcome may be overestimated.
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