Density distribution of the type E2 glenoid in cuff tear arthropathy.


Journal

Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 12 12 2018
revised: 10 04 2019
accepted: 26 05 2019
pubmed: 2 9 2019
medline: 14 3 2020
entrez: 2 9 2019
Statut: ppublish

Résumé

Little is known about the cortical-like and cancellous bone density variations in superiorly eroded glenoids due to cuff tear arthropathy. The purpose of this study was to analyze regional bone density in type E2 glenoids. Clinical shoulder computed tomography scans were obtained from 32 patients with a type E2 superior erosion (10 men and 22 women; mean age, 73 years). Measurement regions were organized into quadrants (superior, inferior, anterior, and posterior) and depth regions. The depth regions were incremented by 2 mm from 0 to 10 mm. A repeated-measures multiple analysis of variance was performed to assess differences and interactions between mean densities (cortical-like and cancellous bone) in each depth, in each quadrant, and between sexes. The lowest cancellous bone density was found in the inferior glenoid quadrant compared with all other quadrants (307 ± 50 Hounsfield units [HU], P < .001). At the glenoid surface, the superior quadrant contained the highest mean density for cortical-like bone (895 ± 97 HU); this differed significantly from the posterior, anterior, and inferior quadrants (P ≤ .033). As for depth of measurement, cortical-like bone was most dense at the glenoid surface (0-2 mm, 892 ± 91 HU), and density decreased significantly at depths greater than 2 mm (P ≤ .019). In patients with type E2 glenoids due to cuff tear arthropathy, the densest bone was found in the superior quadrant in the area of erosion. The inferior quadrant, which tends to be unloaded as the humeral head migrates superiorly, had the lowest density bone. In addition, the best-quality bone was located at the glenoid surface as compared with deeper in the vault.

Sections du résumé

BACKGROUND BACKGROUND
Little is known about the cortical-like and cancellous bone density variations in superiorly eroded glenoids due to cuff tear arthropathy. The purpose of this study was to analyze regional bone density in type E2 glenoids.
METHODS METHODS
Clinical shoulder computed tomography scans were obtained from 32 patients with a type E2 superior erosion (10 men and 22 women; mean age, 73 years). Measurement regions were organized into quadrants (superior, inferior, anterior, and posterior) and depth regions. The depth regions were incremented by 2 mm from 0 to 10 mm. A repeated-measures multiple analysis of variance was performed to assess differences and interactions between mean densities (cortical-like and cancellous bone) in each depth, in each quadrant, and between sexes.
RESULTS RESULTS
The lowest cancellous bone density was found in the inferior glenoid quadrant compared with all other quadrants (307 ± 50 Hounsfield units [HU], P < .001). At the glenoid surface, the superior quadrant contained the highest mean density for cortical-like bone (895 ± 97 HU); this differed significantly from the posterior, anterior, and inferior quadrants (P ≤ .033). As for depth of measurement, cortical-like bone was most dense at the glenoid surface (0-2 mm, 892 ± 91 HU), and density decreased significantly at depths greater than 2 mm (P ≤ .019).
CONCLUSION CONCLUSIONS
In patients with type E2 glenoids due to cuff tear arthropathy, the densest bone was found in the superior quadrant in the area of erosion. The inferior quadrant, which tends to be unloaded as the humeral head migrates superiorly, had the lowest density bone. In addition, the best-quality bone was located at the glenoid surface as compared with deeper in the vault.

Identifiants

pubmed: 31473132
pii: S1058-2746(19)30456-2
doi: 10.1016/j.jse.2019.05.046
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

167-174

Informations de copyright

Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Auteurs

Matthew D Mahaffy (MD)

Department of Biomedical Engineering, The University of Western Ontario, London, ON, Canada; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada.

Nikolas K Knowles (NK)

Department of Biomedical Engineering, The University of Western Ontario, London, ON, Canada; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada.

Carolyn Berkmortel (C)

Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, ON, Canada.

Sejla Abdic (S)

Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada; Department of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria.

Gilles Walch (G)

Centre Orthopédique Santy, Lyon, France.

James A Johnson (JA)

Department of Biomedical Engineering, The University of Western Ontario, London, ON, Canada; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, ON, Canada.

George S Athwal (GS)

Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, ON, Canada. Electronic address: gathwal@uwo.ca.

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Classifications MeSH