Korakoid taşma ile subskapularis yırtıklarının ilişkisi

Amaç: Bu çalışmanın amacı izole subskapularis yırtıklarında etiyolojik bir faktör olan subkorakoid sıkışmada korakoid taşmanın bir risk faktörü olarak geçerliliğini araştırmaktır.Gereç ve Yöntem: Omuz artroskopisi uygulanan hastalardan izole subskapularis ve izole tam kat supraspinatus yırtıklı hastalar randomize olarak seçilerek iki grup oluşturuldu. Manyetik rezonans görüntüleme ve ameliyat videoları retrospektif olarak tekrar incelenerek T1 aksiyel manyetik rezonans görüntüleme kesitlerinde korakoid taşma miktarı ve korakoid taşma/humerus başı çapı oranı hesaplandı ve ortalamaları karşılaştırıldı.Bulgular: Çalışmada her iki grupta 28’er hasta olmak üzere toplam 56 hasta vardı. Hastaların yaş ortalamaları Grup 1 ve 2’de sırasıyla 48.71±9.66 ve 64.85±6.1 olarak bulundu. Cinsiyet ve ameliyat olan taraf bakımından fark yoktu. Ortalama korakoid taşma değerleri Grup 1 ve 2’de sırasıyla 16.08±5.6 ve 14.65±5.92, korakoid taşma/humerus başı çapı oranı ise 0.33±0.11 ve 0.29±0.11 bulundu. Ortalama korakoid taşma ve korakoid taşma/humerus başı çapı değerleri bakımından iki grup arasında anlamlı fark saptanmadı.Sonuç: Korakoid taşma ile subkorakoid sıkışma arasında istatistiksel olarak gerçek anlamda bir ilişki yoktur. Subskapularis yırtıklarında varlığı hala tartışmalı olan subkorakoid sıkışmaya bu çalışma ile de kanıt bulunamamıştır.

Relationship between coracoid overlap and subscapularis tears

Purpose: The aim of this study was to investigate the validity of the coracoid overlap as a risk factor of the subcoracoid impingement which is an etiologic factor in isolated subscapularis tears.Materials and Methods: Two groups were constituted including isolated subscapularis and isolated full-thickness supraspinatus tears selected randomly from patients who underwent shoulder arthroscopy. The magnetic resonance imaging and surgery videos were reviewed retrospectively to calculate and compare the means of the coracoid overlap and coracoid overlap/humeral head diameter ratio measured on T1 transverse magnetic resonance imaging sections.Results: There were a total of 56 patients including 28 in each group. The mean age of the groups were found to be 48.71±9.66 and 64.85±6.1 in Group 1 and 2, respectively. There was no significant difference in terms of age and involved shoulder. The mean coracoid overlap values were found to be 16.08±5.6 and 14.65±5.92 and coracoid overlap/humeral head diameter ratios were found to be 0.33±0.11 and 0.29±0.11 in Groups 1 and 2, respectively. There was no significant difference in terms of coracoid overlap values and coracoid overlap/humeral head diameter ratios Conclusion: There is actually no statistically significant relationship between coracoid overlap and subcoracoid impingement. There could be found no evidence also with this study for subcoracoid impingement which is still controversial in subscapularis tears.

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  • 1. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S. Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion: a study in cadavera. J Bone Joint Surg Am. 1988;70:1224-30.
  • 2. Hallgren HC, Eliasson P, Aspenberg PAdolfsson LE. Elevated plasma levels of TIMP-1 in patients with rotator cuff tear. Acta Orthop. 2012;83:523-8.
  • 3. Gumina S, Arceri V, Carbone S, Albino P, Passaretti D, Campagna V et al. The association between arterial hypertension and rotator cuff tear: the influence on rotator cuff tear sizes. J Shoulder Elbow Surg. 2013;22:229-32.
  • 4. Singh B, Bakti N, Gulihar A. Current concepts in the diagnosis and treatment of shoulder impingement. Indian J Orthop. 2017;51:516-23.
  • 5. Cetinkaya M, Ataoglu MB, Ozer M, Ayanoglu T, Kanatli U. Subscapularis tendon slip number and coracoid overlap are more related parameters for subcoracoid impingement in subscapularis tears: a magnetic resonance imaging comparison study. Arthroscopy. 2017;33:734-42.
  • 6. Cetinkaya M, Ataoglu MB, Ozer M, Ayanoglu T, Oner AY, Kanatli U. Do subscapularis tears really result in superior humeral migration? Acta Orthop Traumatol Turc. 2018.
  • 7. Gumina S, Postacchini F, Orsina L, Cinotti G. The morphometry of the coracoid process - its aetiologic role in subcoracoid impingement syndrome. Int Orthop. 1999;23:198-201.
  • 8. Osti L, Soldati F, Del Buono A, Massari L. Subcoracoid impingement and subscapularis tendon: is there any truth? Muscles Ligaments Tendons J. 2013;3:101-5.
  • 9. Cetinkaya M, Oner AY, Ataoglu MB, Ozer M, Ayanoglu T, Kanatli U. Lesser tuberosity cysts and their relationship with subscapularis tears and subcoracoid impingement. J Orthop Sci. 2017;22:63-8.
  • 10. Dugarte AJ, Davis RJ, Lynch TS, Schickendantz MS, Farrow LD. Anatomic study of subcoracoid morphology in 418 shoulders: potential implications for subcoracoid impingement. Orthop J Sports Med. 2017;5:2325967117731996
  • 11. Torrens C, Alentorn-Geli E, Sanchez JF, Isart A, Santana F. Decreased axial coracoid inclination angle is associated with rotator cuff tears. J Orthop Surg (Hong Kong). 2017;25:2309499017690329.
  • 12. Gerber CKrushell RJ. Isolated rupture of the tendon of the subscapularis muscle: clinical features in 16 cases. J Bone Joint Surg Br. 1991;73:389-94.
  • 13. Deutsch A, Altchek DW, Veltri DM, Potter HG, Warren RF. Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med. 1997;25:13-22.
  • 14. Li XX, Schweitzer ME, Bifano JA, Lerman J, Manton GL, El-Noueam KI. MR evaluation of subscapularis tears. J Comput Assist Tomogr. 1999;23:713-7.
  • 15. Flury MP, John M, Goldhahn J, Schwyzer HK, Simmen BR. Rupture of the subscapularis tendon (isolated or in combination with supraspinatus tear): when is a repair indicated? J Shoulder Elbow Surg. 2006;15:659-64.
  • 16. Denard PJ, Ladermann A, Burkhart SS. Arthroscopic management of subscapularis tears. Sports Med Arthrosc. 2011;19:333-41.
  • 17. Longo UG, Berton A, Marinozzi A, Maffulli N, Denaro V. Subscapularis tears. Med Sport Sci. 2012;57:114-21.
  • 18. Sakurai G, Ozaki J, Tomita Y, Kondo T, Tamai S. Incomplete tears of the subscapularis tendon associated with tears of the supraspinatus tendon: cadaveric and clinical studies. J Shoulder Elbow Surg. 1998;7:510-5.
  • 19. Bennett WF. Arthroscopic repair of isolated subscapularis tears: a prospective cohort with 2- to 4- year follow-up. Arthroscopy. 2003;19:131-43.
  • 20. Barth JR, Burkhart SS, De Beer JF. The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy 2006 22:1076-84.
  • 21. Kim SJ, Jung M, Lee JH, Park JH, Chun YM. Arthroscopic repair of a significant (>50%) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion). J Shoulder Elbow Surg. 2015;24:875-81.
  • 22. Adams CR, Schoolfield JD, Burkhart SS. The results of arthroscopic subscapularis tendon repairs. Arthroscopy. 2008;24:1381-9.
  • 23. Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br. 1985;67:703-8.
  • 24. Goldthwait JE. An anatomic and mechanical study of the shoulder joınt, explaining many of the cases of painful shoulder, many of the recurrent dislocations, and many of the cases of brachial neuralgias or neuritis. Am J Orthop Surg. 1909;6:579-606.
  • 25. Bonutti PM, Norfray JF, Friedman RJ, Genez BM. Kinematic MRI of the shoulder. J Comput Assist Tomogr. 1993;17:666-9.
  • 26. Friedman RJ, Bonutti PM, Genez B. Cine magnetic resonance imaging of the subcoracoid region. Orthopedics. 1998;21:545-8.
  • 27. Richards DP, Burkhart SS, Campbell SE. Relation between narrowed coracohumeral distance and subscapularis tears. Arthroscopy. 2005;21:1223-8.
  • 28. Cay N, Tosun O, Dogan M, Karaoglanoglu M, Bozkurt M. The effect of morphometric relationship between the glenoid fossa and the humeral head on rotator cuff pathology. Acta Orthop Traumatol Turc. 2012;46:325-31.
  • 29. Kircher J, Bittersohl B, Zilkens C, Hedtmann A, Krauspe R. Biometrical analysis of the shoulder joint regarding glenoid implant dimensions for arthroplasty. Surg Radiol Anat. 2014;36:321-5.
  • 30. Pearl ML, Woolwine S, van de Bunt F, Merton G, Burchette R. Geometry of the proximal humeral articular surface in young children: a study to define normal and analyze the dysplasia due to brachial plexus birth palsy. J Shoulder Elbow Surg. 2013;22:1274-84.
  • 31. Dines DM, Warren RF, Inglis AE, Pavlov H. The coracoid impingement syndrome. J Bone Joint Surg Br. 1990;72:314-6.
  • 32. Kleist KD, Freehill MQ, Hamilton L, Buss DDFritts H. Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study. J Shoulder Elbow Surg. 2007;16:245-50.
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
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