腱板断裂関節症における肩甲骨関節窩の形態調査

抄録

Background: There were a few morphologic studies, which investigated in the cuff tear arthropathy (CTA) in Japanese. The purpose of this study is to investigate whether there are any characteristic changes of the primary CTA with CT scans.
Materials: CT scans were obtained of 49 shoulders with CTA of the glenohumeral joint. The measurement was performed at the middle level of the glenoid. Glenoid morphology was assessed qualitatively by measurement of the glenoid retroversion using the technique reported by Friedman et al (1). Morphologic changes of the glenoid were evaluated by Walch's classification (2) as follows; Type A was characterized by a well-centered humeral head and a balanced distribution of strengths against the surface of the glenoid. The erosion may be minor-type A1 or major-type A2. In Type B, the posterior subluxation of the humeral head was responsible for the asymmetric load against the glenoid, particularly the exaggerated posterior wear pattern: B1 showed narrowing of the posterior joint space, subchondral sclerosis, and osteophytes, and type B2 demonstrated a posterior cupula that gave an unusual biconcave aspect to the glenoid. Type C was defined by a glenoid retroversion of more than 25 degree.
Results: Mean Glenoid retroversion was 2.7 ± 5.3°. Morphology was classified as follows; 68% classified in type A, of them A1 in 27% and A2 in 41%. 32% in type B, of them B1 in 29% and B2 in 3%, none in type C.
Conclusion: There are some difference in morphologic study between CTA and the primary glenohumeral osteoarthritis.