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Posterior Rotator Cuff Fatty Infiltration Associated With Increased Posterior Glenoid Wear In Glenohumeral Osteoarthritis: An Mri-Based Study

Posterior Rotator Cuff Fatty Infiltration Associated With Increased Posterior Glenoid Wear In Glenohumeral Osteoarthritis: An Mri-Based Study

Matthew J. Hartwell, MD, UNITED STATES Ryan Elijah Harold, MD Patrick Thomas Sweeney, MD, UNITED STATES Amee L Seitz, PT, DPT, PhD, UNITED STATES Guido Marra, MD Matthew D Saltzman, MD, UNITED STATES

Northwestern Medicine, Chicago, Illinois, UNITED STATES


2021 Congress   Abstract Presentation   5 minutes   Not yet rated

 

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Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Diagnosis Method

MRI

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Summary: This study identified asymmetry in axial plane rotator cuff muscle fatty infiltration in B2 and B3-type glenoids compared to concentrically worn glenoids, with relatively more fatty infiltration of the infraspinatus and teres minor compared to the subscapularis in glenoids with posterior wear pattern.


Purpose

The purpose of this study was to use MRI to assess the association of rotator cuff muscle fatty infiltration and glenoid morphology in primary glenohumeral osteoarthritis.

Background

Rotator cuff atrophy evaluated with computed tomography (CT) scans has been associated with asymmetric glenoid wear and humeral head subluxation in glenohumeral osteoarthritis (GHOA). Magnetic resonance imaging (MRI) has increased sensitivity for identifying rotator cuff pathology compared to CT and has not been used to investigate this relationship.

Methods

132 shoulders from 129 patients with primary GHOA were retrospectively reviewed and basic demographic information was collected. All MRIs were obtained as part of preoperative evaluation prior to total shoulder arthroplasty and were reviewed to assess glenoid morphology and rotator cuff pathology. All patients had intact rotator cuff tendons. Glenoid morphology was assigned using the modified-Walch classification system (types A1, A2, B1, B2, B3, C, and D) and rotator cuff fatty infiltration was assigned using Goutallier scores.

Results

46 (35%) of the shoulders had posterior wear patterns (23 type B2s, 23 type B3s). Both the infraspinatus and teres minor independently had significantly more fatty infiltration in B2 and B3 type glenoids compared to type A glenoids (p<0.001). There was a greater imbalance in posterior rotator cuff muscle fatty infiltration in B2 and B3 type glenoids compared to type A glenoids (p<0.001); however, there was no difference in axial plane Goutallier scores between B2 and B3 glenoids (p=1.00). There was an increased amount of fatty infiltration in the infraspinatus among B2 and B3-type glenoids compared to type A glenoids on multivariate analysis controlling for age and gender (Odds ratios of 71.7 [95% CI 8.2 to 629.0, p<0.001] for B2 glenoids and 64.5 [95% CI 5.8 to 717.9, p<0.001] for B3 glenoids). Males were also found to have increased likelihood of having B2 or B3-type glenoids compared to type A glenoids in the same multivariate analysis (Odds ratios of 4.5 [95% CI 1.1 to 18.1, p=0.034] for B2 glenoids and 12.2 [95% CI 2.4 to 61.7, p=0.0025] for B3 glenoids).

Conclusions

These results identify significant asymmetry in axial plane rotator cuff muscle fatty infiltration in B2 and B3-type glenoids compared to concentrically worn glenoids, with relatively more fatty infiltration of the infraspinatus and teres minor compared to the subscapularis in glenoids with posterior wear pattern.


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