ROTATOR MANŞET YIRTIKLARINDA SKAPULA MORFOLOJİSİNİN ROLÜNÜN İNCELENMESİ: EN KULLANIŞLI PREDİKTÖR HANGİSİ?

Abstract

Amaç: Bu çalışmada glenoid inklinasyon (Gİ), akromial indeks (Aİ), kritik omuz açısı (CSA) ve superior inklinasyon (Sİ) ölçümlerinin semptomatik dejeneratif tam kat supraspinatus tendon yırtıkları (SSY) ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: 2015 ve 2017 yılları arasında SSY tanılı hastaların verileri retrospektif olarak incelendi. SSY tespit edilen 39 hasta ile yaş, cinsiyet ve taraf yönünden eşleştirilmiş SSY olmadığı tespit edilen 39 hasta çalışmaya dahil edildi. Ölçülen Gİ, Aİ, CSA ve Sİ değerleri SSY grubu (n=39) ve kontrol grubu (n=39) arasında karşılaştırıldı. SSY grubunun yaş ortalaması 52,74±5,49 yıl, kontrol grubunun yaş ortalaması 51,15±5,22 yıl idi. Bulgular: Gİ ortalaması yırtık grubunda 19,97°±5,62° iken kontrol grubunda 13,72°±6,55° idi (p<0,001). Aİ ortalaması yırtık grubunda 0,7±0,08, kontrol grubunda ise 0,67±0,07 idi (p=0,035). CSA ortalaması yırtık grubunda 35,05°±4,09°, kontrol grubunda 33,06°±3,42° idi (p=0,022). Sİ ortalaması yırtık grubunda 25,13°±5,71°, kontrol grubunda ise 25,91°±5,81° idi (p=0,552). Gruplar arasında istatistiksel anlamlı farklılık bulunan Gİ, Aİ ve CSA ölçümlerinin duyarlılık, özgünlük ve cut-off değerleri belirlendi. Buna göre Gİ’nin ≥17,35° cut-off değeri için duyarlılığı %79,54 iken özgünlüğü %79,51 idi (p=0,001). Aİ’nin ≥0,67 cutoff değeri icin duyarlılığı %61,54, özgünlüğü %56,4 idi (p=0,031). CSA’nın ≥33,45° cut-off değeri icin duyarlılığı %64,12, özgünlüğü ise %64,54 idi (p=0,014).. Sonuç: Yüksek glenoid inklinasyon, akromial indeks, kritik omuz açısı ölçüm değerleri semptomatik dejeneratif tam kat supraspinatus tendon yırtıkları ile ilişkili iken superior inklinasyon ölçümü ile ilişki saptanmadı. Glenoid inklinasyon ölçümü semptomatik dejeneratif tam kat supraspinatus tendon yırtıklarının öngörülmesinde en yüksek duyarlılık ve özgünlüğe sahipti. 

Keywords

• Akromiyal indeks
• glenoid inklinasyon
• kritik omuz açısı
• rotator manşet yırtığı
• superior inklinasyon

EVALUATING THE ROLE OF SCAPULA MORPHOLOGY IN ROTATOR CUFF TEARS: WHICH IS THE MOST USEFUL PREDICTOR?

Abstract

Objective: The aim of this study was to determine the relationships between glenoid inclination (GI), acromial index (AI), critical shoulder angle (CSA), superior inclination (SI), and symptomatic degenerative full-thickness supraspinatus tears (SSTs). Materials and Methods: Patients who were diagnosed with SSTs (n=39) between 2015 and 2017 were assessed retrospectively. Controls were matched to age, gender, and side. Measured GI, AI, CSA, and SI values were compared between the SSTs and control groups (n=39). The mean age for the SSTs group was 52.74±5.49 years, and the mean age for the control group was 51.15±5.22 years. Results: The mean GI for the SSTs group was 19.97°±5.62°, and it was 13.72°±6.55° for the control group (p<0.001). The mean AI was 0.7±0.08 and 0.67±0.07 in the SSTs and control groups, respectively (p=0.035). The mean CSA for the SSTs group was 35.05°±4.09° and it was 33.06°±3.42° for the control group (p=0.022). The mean SI was 25.13°±5.71° and 25.91°±5.81° in the SSTs and control groups, respectively (p=0.552). For a cut-off value of GI ≥17.35°, sensitivity was 79.54%, and specificity was 79.51% (p=0.001). For a cut-off value of AI ≥0.67, sensitivity was 61.54% and specificity was 56.4% (p=0.031). For a cut-off value of CSA ≥33.45°, sensitivity was 64.12%, and specificity was 64.54% (p=0.014). Conclusion: Higher measurement values of glenoid inclination, acromial index, and critical shoulder angle were associated with symptomatic degenerative full-thickness supraspinatus tears, and no correlation was found with superior inclination measurement. The glenoid inclination measurement had the highest sensitivity and specificity in predicting symptomatic degenerative full-thickness supraspinatus tears. Keywords: 

Keywords

• Acromial index
• critical shoulder angle
• glenoid inclination
• rotator cuff tear
• superior inclination

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