The Association Between Rotator Cuff Muscle Fatty Infiltration and Glenoid Morphology in Glenohumeral Osteoarthritis

Donohue, Kenneth W.; Ricchetti, Eric T.; Ho, Jason; Iannotti, Joseph P.

doi:10.2106/jbjs.17.00232

Cited by 69 publications

(65 citation statements)

References 19 publications

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“…Based on these criteria, we found 10 of the glenoids studied to be Walch D. The relatively high incidence of this morphology may be due to the patient population studied, all of whom were treated by a well-known shoulder surgeon whose practice may attract more advanced shoulder pathology. The inclusion of these 10 Walch D glenoids yields significant findings not reported in previous literature which did not report on Walch D glenoids [8]. Our study cohort did however not have sufficient numbers of B1, B2, or B3 glenoids to corroborate or add to published findings regarding these morphologies [8].…”

Section: Discussioncontrasting

confidence: 43%

“…The inclusion of these 10 Walch D glenoids yields significant findings not reported in previous literature which did not report on Walch D glenoids [8]. Our study cohort did however not have sufficient numbers of B1, B2, or B3 glenoids to corroborate or add to published findings regarding these morphologies [8]. Intra-observer reliability of the proposed glenoid bone loss protocol was near perfect, likely owing to its similarities to the Friedman line method of measuring glenoid version, which has been found to have similarly exceptional reliability [10].…”

Section: Discussionmentioning

confidence: 68%

“…Prior to the acquisition of measurements, scans were reconstructed in the scapular plane, defined by the inferior angle, scapular trigonum, and glenoid midpoint as previously described [8]. All CT measurements were made on an axial slice perpendicular to the scapular plane at the level of the junction of the base of the coracoid and spine of the scapula.…”

Section: Bony Measurementsmentioning

confidence: 99%

“…Studies have shown association of factors, such as glenoid retroversion, and rotator cuff muscle atrophy with poor clinical outcomes including premature hardware loosening and recurrent subluxation of the prosthetic humeral head following anatomic TSA [6,7]. The relationship between both soft tissue and preoperative bone pathologies was recently assessed by Donohue et al who found an association between high-grade rotator cuff muscle fatty infiltration and more severe modified Walch classification subtype, increased joint-line medialization, and increased glenoid retroversion [8]. However, the full spectrum of Walch classification was not studied and inter-rater performance was not assessed.…”

Section: Introductionmentioning

confidence: 99%

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Correction to: Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis

et al. 2020

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Purpose Glenoid bone stock and morphology and rotator cuff muscle quality and tendon integrity affect the outcome of total shoulder arthroplasty. We hypothesized that glenoid bone loss correlates with rotator cuff muscle fatty infiltration (FI), tendinopathy, and atrophy. Design Forty-three 3-D CT scans and MRIs of 43 patients (mean age 62 years; SD 13 years; range 22-77 years) referred for primary shoulder pain were evaluated. Measurements of glenoid bone stock, version, and posterior humeral subluxation index (HSI) were assessed on an axial CT image reconstructed in the true scapular plane. Measurements utilized the Friedman line to approximate the pre-pathologic surface. Glenoid morphology was assigned by modified Walch classification. Rotator cuff FI, atrophy, and tendon integrity were assessed on corresponding MRIs. Results There was a very strong negative correlation between increasing glenoid version and HSI (r = − 0.908; p < 0.0001). There was a moderately negative correlation between anterior bone loss and HSI (r = − 0.562; p < 0.0001) and a moderately positive correlation between posterior bone loss and HSI (r = 0.555; p < 0.0001). Subscapularis muscle FI correlated moderately with increased anterior and central bone loss and increased humeral head medialization (r = 0.512, p = 0.0294; r = 0.479, p = 0.033; r = 0.494, p = 0.0294, respectively). Inter-observer reliability (intra-class correlation coefficient [ICC] and kappa) was good to excellent for all measurements and grading. Conclusion Glenoid anteversion and anterior and posterior bone loss are associated with varying HSI. Subscapularis muscle FI, not tendon integrity, correlates to anterior and central glenoid erosion. The study adds evidence that neither rotator cuff tendinopathy nor muscle atrophy exhibits a significant relationship to HSI.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 68%

Section: Bony Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correction to: Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis

et al. 2020

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“…The mechanism of the development of fatty infiltration has been proposed to be related to a change in the muscle pennation angle that occurs with tendon retraction seen in shoulders with rotator cuff tears 11 . Because the majority of arthritic shoulders do not have full-thickness cuff tears, the mechanisms for the development of fatty infiltration in these shoulders remain unclear 1,3,4,9 . The Goutallier grading system does not allow for a quantitative assessment of rotator cuff muscle size.…”

mentioning

confidence: 99%

Association Between Rotator Cuff Muscle Size and Glenoid Deformity in Primary Glenohumeral Osteoarthritis

Aleem

Chalmers

Bechtold

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Although glenoid morphology has been associated with fatty infiltration of the rotator cuff in arthritic shoulders, the association of rotator cuff muscle area with specific patterns of glenoid wear has not been studied. The purpose of our study was to assess the associations of glenoid deformity in primary glenohumeral osteoarthritis and rotator cuff muscle area. Methods: A retrospective study of 370 computed tomographic (CT) scans of osteoarthritic shoulders was performed. Glenoid deformity according to the modified Walch classification was determined, and retroversion, inclination, and humeral-head subluxation were calculated using automated 3-dimensional software. Rotator cuff muscle area was measured on sagittal CT scan reconstructions. A ratio of the area of the posterior rotator cuff muscles to the subscapularis was calculated to approximate axial plane potential force imbalance. Univariate and multivariate analyses to determine associations with glenoid bone deformity and rotator cuff measurements were performed. Results: Patient age and sex were significantly related to cuff muscle area across glenoid types. Multivariate analysis did not find significant differences in individual rotator cuff cross-sectional areas across glenoid types, with the exception of a larger supraspinatus area in Type-B2 glenoids compared with Type-A glenoids (odds ratio [OR], 1.5; p = 0.04). An increased ratio of the posterior cuff area to the subscapularis area was associated with increased odds of a Type-B2 deformity (OR, 1.3; p = 0.002). Similarly, an increase in this ratio was significantly associated with increased glenoid retroversion (beta = 0.92; p = 0.01) and humeral-head subluxation (beta = 1.48; p = 0.001). Within the Type-B glenoids, only posterior humeral subluxation was related to the ratio of the posterior cuff to the subscapularis (beta = 1.15; p = 0.001). Conclusions: Age and sex are significantly associated with cuff muscle area in arthritic shoulders. Asymmetric glenoid wear and humeral-head subluxation in osteoarthritis are associated with asymmetric atrophy within the rotator cuff transverse plane. Increased posterior rotator cuff muscle area compared with anterior rotator cuff muscle area is associated with greater posterior glenoid wear and subluxation. It is unclear if the results are causative or associative; further research is required to clarify the relationship.

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Radiographic Features of Glenohumeral Arthritis

Razmjou

Christakis

2022

Clinical and Radiological Examination of the Shoulder Joint

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The Association Between Rotator Cuff Muscle Fatty Infiltration and Glenoid Morphology in Glenohumeral Osteoarthritis

Abstract: This study investigates the association between different patterns of glenoid bone loss and rotator cuff muscle fatty infiltration. Both factors have been shown to affect clinical outcome following TSA.

Cited by 69 publications

References 19 publications

Correction to: Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis

Correction to: Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis

Association Between Rotator Cuff Muscle Size and Glenoid Deformity in Primary Glenohumeral Osteoarthritis

Radiographic Features of Glenohumeral Arthritis

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