Is There A Relationship Between Critical Shoulder Angle and Fatty Degeneration and Number of Damaged Tendons in Rotator Cuff Arthropathy Patients?

Cüneyd Günay; Mustafa Kavak

doi:10.20515/otd.998259

Araştırma Makalesi

Is There A Relationship Between Critical Shoulder Angle and Fatty Degeneration and Number of Damaged Tendons in Rotator Cuff Arthropathy Patients?

Yıl 2022, Cilt: 44 Sayı: 1, 120 - 124, 14.01.2022

Cüneyd Günay Mustafa Kavak

https://doi.org/10.20515/otd.998259

Öz

The aim of this study was to investigate the correlation of critical shoulder angle (CSA) in rotator cuff arthropathy patients with number of damaged rotator cuff tendons and muscle fatty degeneration. Rotator cuff arthropathy patients were included in this study. True antero-posterior radiographs (Grashey view) were used to measure the angle by the first author. The critical shoulder angles were measured on radiographs. The Magnetic resonance images (MRI) of same patients were assessed in terms of number of tendon involvements and fatty degeneration of rotator cuff muscles. There were 28 rotator cuff arthropathy patients comprising 16 females and 12 males. The mean age was 69.928.84 years. The right shoulder was affected in 20 patients. The left side was affected in 8 patients. The damaged rotator cuff tendons were as follows; supraspinatus tendon was affected in all patients, infraspinatus tendon was affected in 25 patients, teres minor was affected in 14 patients, and subscapularis tendon was affected in 24 patients. The critical shoulder angle was found 37.601.66 CSA values were found to be higher in patients having fatty degeneration than others having no fatty degeneration, and it was statistically significant (p<0.001). The CSA values were found to be higher in patients with having increased number of damaged tendons and with having fatty degeneration of rotator cuff muscles. The higher CSA means the worse rotator cuff arthropathy patients, therefore care should be taken for planning surgical treatment options.

Anahtar Kelimeler

Critical shoulder angle, shoulder, rotator cuff tears, radiography, fatty degeneration

Kaynakça

1. Günay C. Spesifik Omuz Muayene Testlerinin Klinik Etkinliğinin Araştırılması. Osmangazi Tıp Dergisi. 2020; 42(6): 670-81.
2. Günay C, Kavak M. Comparison of SLAP Lesions on MRI and Arthroscopy. Osmangazi Tıp Dergisi. 2021;43(3):258-65.
3. Bishop JY, Santiago-Torres JE, Rimmke N, Flanigan DC. Smoking Predisposes to Rotator Cuff Pathology and Shoulder Dysfunction: A Systematic Review. Arthroscopy. 2015;31(8):1598-605.
4. Lazarides AL, Alentorn-Geli E, Choi JH, Stuart JJ, Lo IK, Garrigues GE, Taylor DC. Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients. J Shoulder Elbow Surg. 2015;24(11):1834-43.
5. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;(254):92-6.
6. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint?: A radiological study of the critical shoulder angle. Bone Joint J. 2013;95-B(7):935-41.
7. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78-83.
8. Moor BK, Wieser K, Slankamenac K, Gerber C, Bouaicha S. Relationship of individual scapular anatomy and degenerative rotator cuff tears. J Shoulder Elbow Surg. 2014;23(4):536-41.
9. Gerber C, Snedeker JG, Baumgartner D, Viehöfer AF. Supraspinatus tendon load during abduction is dependent on the size of the critical shoulder angle: A biomechanical analysis. J Orthop Res. 2014;32(7):952-7.
10. Garcia GH, Liu JN, Degen RM, Johnson CC, Wong AC, Dines DM, Gulotta LV, Dines JS. Erratum to "Higher critical shoulder angle increases the risk of retear after rotator cuff repair" [J Shoulder Elbow Surg 2017;26:241-245]. J Shoulder Elbow Surg. 2017;26(4):732.
11. Chalmers PN, Salazar D, Steger-May K, Chamberlain AM, Yamaguchi K, Keener JD. Does the Critical Shoulder Angle Correlate With Rotator Cuff Tear Progression? Clin Orthop Relat Res. 2017;475(6):1608-1617.
12. Blonna D, Giani A, Bellato E, Mattei L, Caló M, Rossi R, Castoldi F. Predominance of the critical shoulder angle in the pathogenesis of degenerative diseases of the shoulder. J Shoulder Elbow Surg. 2016;25(8):1328-36.
13. Balke M, Liem D, Greshake O, Hoeher J, Bouillon B, Banerjee M. Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2200-5.
14. Mantell MT, Nelson R, Lowe JT, Endrizzi DP, Jawa A. Critical shoulder angle is associated with full-thickness rotator cuff tears in patients with glenohumeral osteoarthritis. J Shoulder Elbow Surg. 2017;26(12):e376-e381.
15. Scheiderer B, Imhoff FB, Johnson JD, Aglio J, Cote MP, Beitzel K, Imhoff AB, Arciero RA, Mazzocca AD, Morikawa D. Higher Critical Shoulder Angle and Acromion Index Are Associated With Increased Retear Risk After Isolated Supraspinatus Tendon Repair at Short-Term Follow Up. Arthroscopy. 2018;34(10):2748-54.

Rotator manşet artropatili hastalarda kritik omuz açısı ile yağlı dejenerasyon ve hasarlı tendon sayısı arasında ilişki var mıdır?

Yıl 2022, Cilt: 44 Sayı: 1, 120 - 124, 14.01.2022

Cüneyd Günay Mustafa Kavak

https://doi.org/10.20515/otd.998259

Öz

Bu çalışmanın amacı rotator manşet artropatili hastalarda kritik omuz açısının (KOA) hasarlı rotator manşet tendon sayısı ve kasların yağlı dejenerasyonu ile ilişkisini araştırmaktı. Rotator manşet artropatisi hastaları bu çalışmaya dahil edildi. İlk yazar tarafından açıyı ölçmek için gerçek ön-arka radyografiler (Grashey görünümü) kullanıldı. Kritik omuz açıları radyografilerde ölçüldü. Aynı hastaların Manyetik rezonans görüntüleri (MRG), tendon tutulumlarının sayısı ve rotator manşet kaslarının yağlı dejenerasyonu açısından değerlendirildi. 16 kadın ve 12 erkekten oluşan 28 rotator manşet artropati hastası vardı. Ortalama yaş 69.928.84 idi. 20 hastada sağ omuz etkilenmişti. 8 hastada sol taraf etkilenmişti. Hasarlı rotator manşet tendonları şu şekildeydi; Hastaların tamamında supraspinatus tendonu, 25 hastada infraspinatus tendonu, 14 hastada teres minör ve 24 hastada subskapularis tendonu etkilenmişti. Kritik omuz açısı 37.601.66olarak bulundu. Yağlı dejenerasyonu olan hastalarda KOA değerleri, yağlı dejenerasyonu olmayanlara göre daha yüksek bulundu ve istatistiksel olarak anlamlıydı (p<0,001). Hasarlı tendon sayısı fazla olan ve rotator manşet kaslarında yağ dejenerasyonu olan hastalarda KOA değerleri daha yüksek bulundu. Daha yüksek KOA, daha kötü rotator manşet artropati hastaları anlamına gelir, bu nedenle cerrahi tedavi seçeneklerinin planlanması için özen gösterilmelidir.

Anahtar Kelimeler

Kritik omuz açısı, omuz, rotator manşet yırtığı, radyografi, yağlı dejenerasyon

Kaynakça

1. Günay C. Spesifik Omuz Muayene Testlerinin Klinik Etkinliğinin Araştırılması. Osmangazi Tıp Dergisi. 2020; 42(6): 670-81.
2. Günay C, Kavak M. Comparison of SLAP Lesions on MRI and Arthroscopy. Osmangazi Tıp Dergisi. 2021;43(3):258-65.
3. Bishop JY, Santiago-Torres JE, Rimmke N, Flanigan DC. Smoking Predisposes to Rotator Cuff Pathology and Shoulder Dysfunction: A Systematic Review. Arthroscopy. 2015;31(8):1598-605.
4. Lazarides AL, Alentorn-Geli E, Choi JH, Stuart JJ, Lo IK, Garrigues GE, Taylor DC. Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients. J Shoulder Elbow Surg. 2015;24(11):1834-43.
5. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;(254):92-6.
6. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint?: A radiological study of the critical shoulder angle. Bone Joint J. 2013;95-B(7):935-41.
7. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78-83.
8. Moor BK, Wieser K, Slankamenac K, Gerber C, Bouaicha S. Relationship of individual scapular anatomy and degenerative rotator cuff tears. J Shoulder Elbow Surg. 2014;23(4):536-41.
9. Gerber C, Snedeker JG, Baumgartner D, Viehöfer AF. Supraspinatus tendon load during abduction is dependent on the size of the critical shoulder angle: A biomechanical analysis. J Orthop Res. 2014;32(7):952-7.
10. Garcia GH, Liu JN, Degen RM, Johnson CC, Wong AC, Dines DM, Gulotta LV, Dines JS. Erratum to "Higher critical shoulder angle increases the risk of retear after rotator cuff repair" [J Shoulder Elbow Surg 2017;26:241-245]. J Shoulder Elbow Surg. 2017;26(4):732.
11. Chalmers PN, Salazar D, Steger-May K, Chamberlain AM, Yamaguchi K, Keener JD. Does the Critical Shoulder Angle Correlate With Rotator Cuff Tear Progression? Clin Orthop Relat Res. 2017;475(6):1608-1617.
12. Blonna D, Giani A, Bellato E, Mattei L, Caló M, Rossi R, Castoldi F. Predominance of the critical shoulder angle in the pathogenesis of degenerative diseases of the shoulder. J Shoulder Elbow Surg. 2016;25(8):1328-36.
13. Balke M, Liem D, Greshake O, Hoeher J, Bouillon B, Banerjee M. Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2200-5.
14. Mantell MT, Nelson R, Lowe JT, Endrizzi DP, Jawa A. Critical shoulder angle is associated with full-thickness rotator cuff tears in patients with glenohumeral osteoarthritis. J Shoulder Elbow Surg. 2017;26(12):e376-e381.
15. Scheiderer B, Imhoff FB, Johnson JD, Aglio J, Cote MP, Beitzel K, Imhoff AB, Arciero RA, Mazzocca AD, Morikawa D. Higher Critical Shoulder Angle and Acromion Index Are Associated With Increased Retear Risk After Isolated Supraspinatus Tendon Repair at Short-Term Follow Up. Arthroscopy. 2018;34(10):2748-54.

Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Sağlık Kurumları Yönetimi
Bölüm	ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar	Cüneyd Günay 0000-0002-5050-3701 Mustafa Kavak 0000-0002-0280-2088
Yayımlanma Tarihi	14 Ocak 2022
Yayımlandığı Sayı	Yıl 2022 Cilt: 44 Sayı: 1

Kaynak Göster

Vancouver	Günay C, Kavak M. Is There A Relationship Between Critical Shoulder Angle and Fatty Degeneration and Number of Damaged Tendons in Rotator Cuff Arthropathy Patients?. Osmangazi Tıp Dergisi. 2022;44(1):120-4.