Factors Associated With Supraspinatus Atrophy in Patients 50 Years and Older With Atraumatic Shoulder Pain.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2024-12-20 eCollection Date: 2024-12-01 DOI:10.1177/23259671241303502
Meghashyama K S, Furquan Ulhaque, Mohan Madhav Desai
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引用次数: 0

Abstract

Background: Atrophy and fatty infiltration of the supraspinatus (SS) muscle are prognostic indicators of poor functional outcomes and higher retear rates after rotator cuff repair. While older patients, female patients, and those with massive and retracted rotator cuff tears are at a higher risk for these indicators, it is unclear whether tear characteristics, acromion morphology, and acromioclavicular (AC) joint arthritis affect SS atrophy in older patients with chronic shoulder pain.

Purpose: To investigate the multifactorial influences associated with SS atrophy in rotator cuff tears.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: A review was conducted on 391 patients with atraumatic shoulder pain (mean age, 60.88 ± 8 years; range, 50-93 years; 200 men and 191 women) who underwent magnetic resonance imaging between May 2019 and April 2020. SS atrophy was calculated using the occupation ratio. Logistic regression was performed to evaluate the association of SS atrophy with patient age and sex, rotator cuff tear type (partial- vs full-thickness), anteroposterior (AP) tear size, AC and glenohumeral (GH) joint arthritis, and acromion shape. A subgroup analysis was performed in patients without tears to investigate whether SS atrophy and fatty infiltration were independent phenomena.

Results: Overall, 91 patients had full-thickness tears without retraction, 131 had partial-thickness tears, and 169 had no tears. The prevalence of SS atrophy was associated with patient age and was more prevalent in women (67.6%), full-thickness tears (91.1%), an AP tear size of >15 mm (92.6%), and GH joint arthritis (100%) (P < .001 for all). The severity of atrophy (indicated by a decrease in the occupation ratio) increased with older age. In the patients without tears, SS atrophy prevalence was 33.1%. Logistic regression analysis showed significant independent associations of SS atrophy with age (P < .001), female sex (P < .001), nonretracted full-thickness tears (P < .001), an AP tear size of >15 mm (P < .001), and hook-shaped acromion (P = .007). A subgroup analysis of the nontear group revealed a significant association of SS atrophy with fatty infiltration (P < .001).

Conclusion: This study identified significant associations between SS atrophy and older age, female sex, full-thickness tear without retraction, an AP tear size of >15 mm, and hook-shaped acromion. Notably, partial-thickness tears were not significantly associated with SS atrophy.

50岁及以上非外伤性肩痛患者冈上肌萎缩的相关因素。
背景:冈上肌(SS)萎缩和脂肪浸润是肩袖修复术后功能不良和高撕裂率的预后指标。虽然老年患者、女性患者以及肩袖撕裂严重且退缩的患者在这些指标上的风险更高,但撕裂特征、肩峰形态和肩锁关节关节炎是否影响老年慢性肩痛患者的SS萎缩尚不清楚。目的:探讨肩袖撕裂后SS萎缩的多因素影响。研究设计:横断面研究;证据水平,3。方法:对391例非外伤性肩痛患者(平均年龄60.88±8岁;范围:50-93岁;在2019年5月至2020年4月期间接受了磁共振成像的200名男性和191名女性。SS萎缩用占用率计算。采用Logistic回归来评估SS萎缩与患者年龄和性别、肩袖撕裂类型(部分或全层)、前后(AP)撕裂大小、AC和肩关节关节炎(GH)以及肩峰形状的关系。对无撕裂患者进行亚组分析,探讨SS萎缩和脂肪浸润是否为独立现象。结果:总体而言,91例患者有全层撕裂,无牵回,131例有部分层撕裂,169例无撕裂。SS萎缩的患病率与患者年龄相关,在女性(67.6%)、全层撕裂(91.1%)、AP撕裂大小为bbb15 mm(92.6%)和GH关节关节炎(100%)中更为普遍(P < 0.001)。萎缩的严重程度随着年龄的增长而增加(通过职业比例的下降来表示)。在无撕裂的患者中,SS萎缩发生率为33.1%。Logistic回归分析显示,SS萎缩与年龄(P < 0.001)、女性(P < 0.001)、未收缩全层撕裂(P < 0.001)、AP撕裂大小(P < 0.001)和钩状肩峰(P = 0.007)有显著的独立相关性。非撕裂组的亚组分析显示,SS萎缩与脂肪浸润有显著相关性(P < 0.001)。结论:本研究发现SS萎缩与年龄、女性、无回缩全层撕裂、AP撕裂大小为> - 15mm和钩状肩峰有显著相关性。值得注意的是,部分厚度撕裂与SS萎缩无显著相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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