Greater tuberosity index–another piece of the puzzle? - 19/12/17
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Résumé |
Introduction |
There are multiple factors contributing to the occurrence of rotator cuff tears and the role of anatomic variations as risk factors for degenerative changes are poorly understood. Some authors relate these lesions to aggressive anatomic alterations, such as the Critical Shoulder Angle, Lateral Acromion Index or the acromion shape or angle. With this in mind, the authors proposed to evaluate the relationship between an increased lateral projection of the greater tuberosity of the humerus and the presence of rotator cuff tear and also the relationship between this anatomic variation of the greater tuberosity and the insertion of the infraspinatus tendon.
Methods |
The great tuberosity index (GTI) was assessed on true anteroposterior radiographs with neutral positioning of the arm. Two concentric circles were drawn using the geometric center of the humeral head as center reference, with the radii focused on the articular surface for the first circle and the second circle drawn tangent to the greater tuberosity. The GTI was then calculated using the relation between the measured distances. This index was determined prospectively in a group of 61 patients divided into two groups. The first group of 31 patients presenting rotator cuff tear in Magnetic Resonance Imaging (MRI) and arthroscopic evaluation of rotator cuff insertion (average age, 59.4±9 years) and the second group of 30 patients presenting intact cuffs in MRI evaluation, (average age, 58.1±6.45 years), with comparable age and gender distribution.
Results |
Higher GTI values were found in the rotator cuff tear groups (p>0.05). There was an average GTI of 1.24±0.041 in patients with rotator cuff tears and an average GTI of 1.15±0.045 in the control group. The inter-observer correlation for this method of evaluation was good (Pearson: r=0.993; p>0.01).
Discussion |
Although the GTI possible association with rotator cuff tears as been sugested by Richard Nyfeller, no study has been published related to this subject. Further studies are necessary to access this parameter, but it seems that the anatomic variations in the greater tuberosity found in our study suggest that this association could be present in patients with an average GTI superior to 1.24.
Conclusion |
Patients presenting high GTI values may have increased risk of developing full thickness tears of the rotator cuff.
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Vol 103 - N° 8S
P. S258-S259 - décembre 2017 Retour au numéro
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