Coracoid morphology and humeral version as risk factors for subscapularis tears

Leite, Maria João; Pinho, André; Sá, Márcia C.; Silva, Miguel R.; Sousa, Alexandra; Torres, João

doi:10.1016/j.jse.2020.01.074

Cited by 16 publications

(12 citation statements)

References 12 publications

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“…Previous studies implied that the morphology of the coracoid process could affect the development and progression of SSC tendinopathy [ 24 , 29 , 37 ]. Leite M. J et al pointed out that coracoid distal length (CLD) and coracoid angle (CA) were associated with SSC tendon tears [ 38 ]. But in clinical practice, we found that it was difficult to select an ideal measurement plane on MRI according to the defined method, and the clinical practicability was poor.…”

Section: Discussionmentioning

confidence: 99%

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Wang

Xue

2022

BMC Musculoskelet Disord

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Background There are still some challenges in diagnosing subscapularis (SSC) tendon tears as accurately as posterosuperior rotator cuff tears on MRI. The omission of SSC tendon tear can lead to muscle atrophy, fatty infiltration, and increased tearing accompanied by aggravated shoulder pain and loss of function. An effective non-invasive evaluation tool will be beneficial to early identification and intervention. The study aims to identify sensitive predictors associated with SSC tendon tears and develop a risk prediction model to assist in diagnosis. Methods Data on 660 patients who received shoulder arthroscopic surgery with preoperative shoulder MRI were collected retrospectively. Of these, patients with SSC tendon tears were defined as the SSC tear group, and patients with intact SSC tendon were enrolled in the non-SSC tear group. Logistic regression analysis was used to identify the key predictors of SSC tendon tears which were then incorporated into the nomogram. Results Among 22 candidate factors, five independent factors including coracohumeral distance (CHD, oblique sagittal plane) (OR, 0.75; 95%CI, [0.67–0.84]), fluid accumulation (Y-face) (OR, 2.29; 95%CI, [1.20–4.38]), long head of biceps tendon (LHB) dislocation/subluxation (OR, 3.62; 95%CI, [1.96–6.68]), number of posterosuperior (PS) rotator cuff tears (OR, 5.36; 95%CI, [3.12–9.22]), and MRI diagnosis (based on direct signs) (OR, 1.88; 95%CI, [1.06–3.32]) were identified as key predictors associated with SSC tendon tears. Incorporating these predictors, the nomogram achieved a good C index with a good agreement on the risk estimation of calibration plots. Higher total points of the nomogram were associated with a greater risk of SSC tendon tears. Conclusion When evaluating the severity of SSC tendon injury, the combination of reliable predictors can improve the sensitivity and diagnostic performance of MRI. This model provides an individualized probability of risk prediction, which is convenient for clinicians to identify patients at high risk for SSC tendon tears to avoid missed diagnosis.

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Section: Discussionmentioning

confidence: 99%

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Wang

Xue

2022

BMC Musculoskelet Disord

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“…The use of CT involves exposure to ionising radiation which must be considered. Other imaging modalities such as MRI 18 have been used to measure humeral version however cost and access are limitations. The use of three-dimensional CT reconstructions may be more favourable, however two dimensional CT scans have been well established in the literature in the use calculating humeral version.…”

Section: Discussionmentioning

confidence: 99%

Inter and Intra-Rater Reliability of Using Computed Tomography to Assess Prosthesis Position Post Shoulder Arthroplasty

Kelly¹,

Karamfiles²,

Coward³

et al. 2020

Journal of Shoulder and Elbow Arthroplasty

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Background Computer models and cadaveric studies have demonstrated that humeral version has a significant impact on the impingement, stability, and range of motion of the prosthetic shoulder joint. Computed tomography (CT) has been used to measure native humeral version, however the reliability of using CT to measure humeral version post reverse total shoulder replacement has not yet been established. Aims To investigate the inter and intra-rater reliability of using CT to assess the post-operative humeral version following shoulder arthroplasty. Methodology Patients underwent a limited CT scan of the operative limb; positioned and protocoled by one consultant radiologist on one machine. The humeral version of the prostheses was calculated individually by two experienced, board certified consultant radiologists. They were blinded to each other’s measurements. The humeral version was calculated using the epicondylar axis. Data Overall, 20 shoulders are included; 12 females (60%), and 10 left-sided (50%). The median anteversion was 0° (range 33° retroversion–27° anteversion; IQ 6.75° retroversion–4.75° anteversion). The inter-rater reliability was 0.985 (95% CI: 0.964–0.994). The intra-rater reliability for radiologist A was 0.988 (95% CI: 0.969–0.995), and the intra-rater reliability for radiologist B was 0.976 (95% CI: 0.942–0.991). Conclusion The use of post operative CT has excellent inter and intra-rater reliability in measuring humeral version following shoulder arthroplasty. This study will facilitate future research regarding impact of the humeral version on patient outcomes.

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“…The usability of many parameters in the preliminary diagnosis of SS rupture has been evaluated by researchers. These include coraco-humeral distance (the shortest distance between the coracoid process and the tuberculum minus on axial views) [5][6][7][8][9][10][11][12][13][14], coracoid morphology (type A: flat coracoid, type B: osteophyte at the tip of the coracoid, type C: hooked coracoid) [12,13,15], coracoid angle (the angle between the long axes of the proximal and distal segments of the coracoid process on T1-weighted oblique sagittal views) [15], coraco-glenoid angle (the angle between a line running from the most distal part of the coracoid process to the anterior glenoid corner and a line running along the plane of the glenoid surface on axial views) [7,14], coraco-humeral angle (the angle between lines drawn tangentially from the tip of the coracoid process to the medial and lateral aspects of the humeral head on axial views) [7,14], coracoid overlap (the distance between the most distal part of the coracoid process and the glenoid on axial views) [8,14], coracoid body-glenoid angle (the angle between a line running along the plane of the glenoid surface and the coracoid body on axial views) [16], coracoid tip-glenoid angle (the angle between a line running along the plane of the glenoid surface and the coracoid tip on axial views) [16], coracoid tip-body angle (the angle between the coracoid body and the coracoid tip on axial views) [16], coraco-scapular angle (the angle between the base of the coracoid and the scapular line on axial views, it was defined as the coracoid angle in the original study) [17], coraco-lesser tuberosity angle (it was not included in the study because it was calculated from radiography) [18], lesser tuberosity angle (the angle between the vertical line that equally divides the line connecting the anterior and posterior cartilage of the humeral head and the most prominent part of the lesser tuberosity on axial views) [18], and lesser tuberosity height (the distance between the line from the margin of the anterior cartilage to the baseline of the bicipital groove and the parallel line passing the most prominent edge of the tuberculum minus on axial views) …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Preoperative Magnetic Resonance Imaging Parameters with Arthroscopic Validation of Subscapularis Tendon Abnormalities in 187 Patients at a Single Center in Turkey

Ilyas

Senyuva

Ipci³

2023

Med Sci Monit

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Background:This study from a single center in Turkey aimed to evaluate preoperative magnetic resonance imaging (MRI) parameters with arthroscopic validation of subscapularis (SS) tendon abnormalities in 187 patients. Material/Methods:Preoperative MRI scans of 187 patients who had undergone arthroscopic shoulder surgery by the senior author (all in lateral decubitus position) were evaluated by 3 researchers. Patients with arthroscopically proven SS tendon rupture (n=69) and without rupture (n=118) were divided into 2 groups and compared with various distances and angles. The following parameters were measured: coracohumeral distance (CHD), coracoid morphology, coraco-glenoid angle (CGA), coracoid angle (CA), coraco-humeral angle (CHA), coracoid overlap (CO), coracoid body-glenoid angle (CBGA), coracoid tip-glenoid angle (CTGA), coracoid tip-body angle (CTBA), coraco-scapular angle (CSA), lesser tuberosity angle (LTA), and lesser tuberosity height (LTH). Results:CHD, CHA, CA, and LTA values decreased in the SS tendon rupture group; coracoid type grade and CO increased (all P<0.001, excluding LTA [P=0.022]). The cut-off values of these measurements were CHD=7.25 mm, CHA=107.25°, CA=111.5°, LTA=31.7°, and CO=16.5 mm. The differences in CGA and CBGA values were not statistically significant (P=0.11, 0.441, respectively). CTGA, CTBA, LTH, and CSA measurements were not included in the intergroup comparisons due to insufficient inter-observer reliability (k=0.478, 0.239, 0.496, 0.309, respectively). Power (1-b) in post hoc analysis was calculated as 0.941. Conclusions:SS tendon rupture was associated with a reduction in the parameters of CHD, CHA, CA, and LTA and an increase in CO on MRI.

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Coracoid morphology and humeral version as risk factors for subscapularis tears

Cited by 16 publications

References 12 publications

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Inter and Intra-Rater Reliability of Using Computed Tomography to Assess Prosthesis Position Post Shoulder Arthroplasty

Evaluation of Preoperative Magnetic Resonance Imaging Parameters with Arthroscopic Validation of Subscapularis Tendon Abnormalities in 187 Patients at a Single Center in Turkey

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