The robustness of glenohumeral centering measurements in dependence of shoulder rotation and their predictive value in shoulders with rotator cuff tears,Skeletal Radiology

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The robustness of glenohumeral centering measurements in dependence of shoulder rotation and their predictive value in shoulders with rotator cuff tears
Skeletal Radiology ( IF 1.9 ) Pub Date : 2022-08-25 , DOI: 10.1007/s00256-022-04159-6
Rainer J Egli _{1,

2} , Emma C J Widmer ₁ , Manuel Waltenspül ₃ , Samy Bouaicha ₃ , Reto Sutter ₁

Affiliation

Objective

De-centering of the shoulder joint on radiographs is used as indicator for severity of rotator cuff tears and as predictor for clinical outcome after surgery. The objective of the study was to assess the effect of malrotation on glenohumeral centering on radiographs and to identify the most reliable parameter for its quantification.

Subjects and methods.

In this retrospective study (2014–2018), 249 shoulders were included: 92 with imaging-confirmed supra- and infraspinatus tears (rupture; 65.2 ± 9.9 years) and 157 without tears (control; 41.1 ± 13.0 years). On radiographs in neutral position and external rotation, we assessed three radiographic parameters to quantify glenohumeral centering: acromiohumeral distance (ACHD), craniocaudal distance of the humeral head and glenoid center (Deutsch), and scapulohumeral arch congruity (Moloney). Non-parametric statistics was performed.

Results

In both positions, only the distance parameters ACHD (< 0.5 mm) and Deutsch (< 1 mm) were comparable in the two study groups rupture and control. Comparing the parameters between the study groups revealed only ACHD to be significantly different with a reduction of more than 2 mm in the rupture group. Among the parameters, ACHD ≤ 6 mm was the only cut-off discriminating rupture (12–21% of the shoulders with ACHD ≤ 6 mm) and control (none of the shoulders with ACHD ≤ 6 mm). Ninety percent of shoulders with ACHD ≤ 6 mm presented with a massive rotator cuff tear (defined as ≥ 67% of the greater tuberosity exposed).

Conclusion

Glenohumeral centering assessed by ACHD and Deutsch is not affected by rotation in shoulders with and without rotator cuff tear. An ACHD ≤ 6 mm has a positive predictive value of 90% for a massive rotator cuff tear.

中文翻译：

肩关节旋转依赖性盂肱对中测量的稳健性及其对肩袖撕裂肩部的预测价值

客观的

X 线片上肩关节的偏心被用作肩袖撕裂严重程度的指标和手术后临床结果的预测指标。该研究的目的是评估旋转不良对 X 线片上盂肱关节中心的影响，并确定最可靠的量化参数。

主题和方法。

在这项回顾性研究（2014-2018 年）中，包括 249 个肩膀：92 个有影像学证实的冈上肌和下肌撕裂（破裂；65.2 ± 9.9 岁）和 157 个没有撕裂（对照；41.1 ± 13.0 岁）。在中立位和外旋的 X 光片上，我们评估了三个 X 光片参数来量化盂肱关节中心：肩肱距离 (ACHD)、肱骨头和关节盂中心的头尾距离 (Deutsch) 以及肩肱弓一致性 (Moloney)。进行了非参数统计。

结果

在这两个位置，只有距离参数 ACHD（< 0.5 毫米）和 Deutsch（< 1 毫米）在两个研究组破裂和控制中具有可比性。比较研究组之间的参数显示只有 ACHD 有显着差异，破裂组减少超过 2 毫米。在这些参数中，ACHD ≤ 6 mm 是唯一区分破裂（12-21% 的 ACHD ≤ 6 mm 的肩部）和对照（没有 ACHD ≤ 6 mm 的肩部）的截断值。90% 的 ACHD ≤ 6 mm 的肩部表现为巨大的肩袖撕裂（定义为 ≥ 67% 的大结节暴露）。