In vivo microstructural analysis of the humeral greater tuberosity in patients with rotator cuff tears using multidetector row computed tomography

BMC Musculoskeletal Disorders

Yasuhito Tanaka¹  Mitsuru Munemoto¹  Tomohisa Hashiuchi²  Goro Sakurai²  Kazuya Inoue¹  Akira Kido¹  Yoshihiro Sakamoto¹ 

[1] Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8521, Japan;Department of Orthopaedic Surgery, Nishinara Chuo Hospital, Nara, Japan

关键词: Suture anchor pullout;    Rotator cuff tear;    Trabecular structure;    Microstructure;    Osteoporosis;   

Others  :  1118640
DOI  :  10.1186/1471-2474-15-351

 received in 2014-05-27, accepted in 2014-10-03,  发布年份 2014

【 摘 要 】

Background

In arthroscopic surgery, the suture anchor technique has become popular for rotator cuff repair. Preoperative evaluation of the bone microstructure is of utmost importance because, especially in elderly patients, osteoporotic changes may cause anchor pullout, which results in failure of rotator cuff repair. Many groups have reported humeral microstructural analysis; however, most studies were experiments using porcine specimens or human cadavers. In this study, we used multidetector row computed tomography to successfully perform in vivo evaluation of the bone microstructure of the humeral greater tuberosity in patients with rotator cuff tears.

Methods

Ten patients were examined. Regions of interest were defined in six quadrants of the greater tuberosity (medial, lateral, and far lateral rows of the anterior and posterior areas). The local bone mineral density and the trabecular microstructural parameters, including the mean bone volume to total volume (BV/TV), trabecular thickness, trabecular separation, and structure model index (SMI), were measured using bone analysis software.

Results

The BV/TV of the posteromedial region was highest and the SMI of the posteromedial region was lowest. These findings suggest that the bone quality of the posteromedial portion is the highest within the greater tuberosity.

Conclusion

Because the bone quality may be correlated with the pullout strength of suture anchors, our method can help to understand the individual and regional variance in bone quality and may lead to the creation of personalized surgical protocols.

【 授权许可】

   
2014 Sakamoto et al.; licensee BioMed Central Ltd.

【 图 表 】

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